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Text File  |  1996-09-20  |  3KB  |  59 lines
  1.                                                         CD-ROM ORDER FORM                            
  2.  
  3. Name:_____________________________________________________
  4.  
  5. Address:___________________________________________________
  6.                             
  7. Phone #:___________________________________________________
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  9. Payment:    MC______                Visa_______        
  10.  
  11. Card #:____________________________________                    Expiration:_________        
  12.                             
  13. Signature:________________________________________________________                            
  14.                             
  15. Quantity    Description                                                                                             Unit Price           Total
  16.                  Bubblegum Crisis Video Screen Saver            Now Available        34.95    
  17.                  Project A-KO Video Screen Saver                  Now Available        34.95    
  18.                  Ranma 1/2 Video Screen Saver                      Now Available        34.95    
  19.                  Tenchi Muyo! Video Screen Saver                   Now Available      34.95    
  20.     
  21.              Record of Lodoss Wars[]Vol 1 []Vol 2 []Vol 3 []Vol 4 Now Avail 24.95 each    
  22.                Record of Lodoss Wars all 4 Volumes together            Now Available        79.95    
  23.  
  24.                La Blue Girl  [ ]Volume 1*   [ ]Volume 2*            Now Available        24.95 each    
  25.  
  26.                Urotsukidoji III[]Vol 1* []Vol 2* []Vol 3* []Vol 4* Now Available        14.95 each    
  27.                Urotsukidoji III all 4 Volumes together*                     Now Available        49.95
  28.     
  29.                CyberCity OEDO 808 Data One w/2 free comic books            Now Available        10.00    
  30.     
  31.              Adventure Kid Volume 1*                             Now Available        14.95    
  32.                Adventure Kid Volume 2*                             Now Available        14.95    
  33.  
  34.                Legend of Lemnear                                       Now Available      19.95    
  35.                Cybernetics Guardian                                   Now Available      19.95    
  36.                Iria Zeiram the Animation Volume 1            Now Available        24.95    
  37.                Iria Zeiram the Animation Volume 2            Now Available        24.95    
  38.                Roujin Z                                                       Now Available        19.95        
  39.                Venus Wars                                                  Now Available        19.95    
  40.                Dominion Tank Police                             Now Available        19.95    
  41.                Lum - Beautiful Dreamer Movie 2                Now Available         24.95
  42.  
  43.                                                                                                                   Shipping & Handling                        
  44.  
  45.     *These are Adult Titles - Must be 18 Years or Older                                                         Subtotal    
  46.  
  47. Please circle which volume you are ordering                        Sales Tax (NYS residents add sales tax)    
  48.                                                                                                                                                   Total    
  49.                             
  50. Please specify how you would like your package sent:                            
  51.  
  52. Shipping & Handling Costs             _____UPS Ground    _____UPS 2nd Day        _____Next Day Air    
  53.                UPS Grnd    2 Day Air     2nd Day Air        Next Day            US Mail         Priority Mail    
  54. 1 Item      $7.00        $9.00             $13.00               $19.00               $10.00           $15.00     
  55. 2 Items    $8.00        $10.00           $14.00               $20.00               $12.00           $17.00     
  56. 3 Items    $9.00        $11.00           $15.00               $21.00               $14.00           $19.00     
  57.     (within the continental US)(Hawaii & Alaska)    (US)    (Canada Only)        
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