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Text File  |  1991-11-17  |  3KB  |  69 lines
  1. Order form for Alchemy Mindworks' shareware.
  2.  
  3. Name (yours) _________________________________________________________
  4.  
  5. Address (likewise, yours) ____________________________________________
  6.  
  7.               ____________________________________________
  8.  
  9. City/town ____________________________________________________________
  10.  
  11. Province/state _______________________Post/zip code __________________
  12.  
  13. Country ______________________________________________________________
  14.  
  15. Daytime phone number _________________________________________________
  16.  
  17. FAX number ___________________________________________________________
  18.  
  19. Computer used (no idea why we want to know this) _____________________
  20.  
  21. Payment: [ ] Visa (see below)              [ ] Cheque
  22.      [ ] Cash (take your chances)    [ ] Other (no chickens, please)
  23.  
  24. I'd like to order the following Alchemy Mindworks shareware:
  25.  
  26. [ ] Graphic Workshop                                         $40.00
  27. [ ] GrafCat                                                  $40.00
  28. [ ] Desktop Paint (monochrome)                               $40.00
  29. [ ] Desktop Paint 256                                        $40.00
  30. [ ] Desktop Paint font toolkit disk                          $10.00
  31. [ ] Graphic Workshop update for previously registered copy   $20.00
  32. [ ] GrafCat update for previously registered copy            $20.00
  33. [ ] Desktop Paint update for previously registered copy      $20.00
  34. [ ] Desktop Paint 256 update for previously registered copy  $20.00
  35. [ ] Other
  36. _______________________________________________________________________
  37.  
  38. Canadian residents please add GST (it wasn't our idea)    _____________
  39.  
  40. Ontario residents please add PST (nor this)               _____________
  41.  
  42. TOTAL                                                     _____________
  43.  
  44. If you're ordering from outside Canada, please make your payment in US
  45. dollars. The exchange more or less covers the extra postage.
  46. _______________________________________________________________________
  47.  
  48. Payment by Visa card:
  49.  
  50. We can only accept Visa cards (no American Express or MasterCards, please.)
  51. We will need the following information:
  52.  
  53. Credit card number: ______________________________________________________
  54.  
  55. Expiry date: _____________________________________________________________
  56.  
  57. Bank the card's drawn on: ________________________________________________
  58.  
  59. The name as it appears on the card: ______________________________________
  60.  
  61. The signature of its owner authorizing us
  62. to debit it for the amount indicated above: ______________________________
  63.  
  64. _______________________________________________________________________
  65.  
  66. Mail this form to:    Alchemy Mindworks Inc., P.O. Box 500, Beeton,
  67.               Ontario L0G 1A0, Canada. If you're paying by
  68.               credit card, you can FAX it to (416) 729-4156.
  69.