home *** CD-ROM | disk | FTP | other *** search
/ Mega A/V / mega_av.zip / mega_av / SOUNDUTL / REPLA101.ZIP / ORDERF.ORM < prev    next >
Text File  |  1990-01-13  |  1KB  |  37 lines
  1.                   REplay SOURCE CODE ORDER FORM
  2.  
  3. NAME:          ___________________________________
  4. STREET:        ___________________________________
  5. CITY:          ___________________________________
  6. PROV/STATE:    ___________________________________
  7. POST/ZIP CODE: ___________________________________
  8.  
  9. I REQUEST THE SOURCE CODE ON THE FOLLOWING FORMAT:
  10.  
  11.           __ 360K 5 1/4" FLOPPY DISK
  12.           __ 720K 3 1/2" FLOPPY DISK
  13.           __ PRINTED FORM
  14.  
  15. I ENCLOSE $15.00 IN THE FORM OF:
  16.  
  17.           __ PERSONAL CHEQUE
  18.           __ MONEY ORDER
  19.  
  20. (ABOVE MADE PAYABLE TO RICHARD E. ZOBELL)
  21.  
  22. COMMENTS:      ___________________________________
  23.                ___________________________________
  24.                ___________________________________
  25.                ___________________________________
  26.                ___________________________________
  27.  
  28. _________________________________________________________________
  29.  
  30. DETATCH AND MAIL ABOVE TO:
  31.  
  32.  
  33. RICHARD E. ZOBELL
  34. 24 RIVERGREEN CRESENT S.E.
  35. CALGARY, AB., CANADA
  36. T2C 3V5
  37.