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Text File  |  1993-04-15  |  2KB  |  61 lines

  1.                       comTAP(tm) VERSION 2.1x ORDER FORM             001
  2.  
  3.  
  4.         Name _____________________________   Telephone (____)____-______
  5.  
  6.         Company ______________________________________   Dept. _________
  7.  
  8.         Street Address _________________________________________________
  9.  
  10.         City ___________________________________________________________
  11.  
  12.         State ___________________________   Zip Code __________-________
  13.  
  14.  
  15.                    SHIPPING ADDRESS (if different from above)
  16.  
  17.  
  18.         Street Address _________________________________________________
  19.  
  20.         City ___________________________________________________________
  21.  
  22.         State ___________________________   Zip Code __________-________
  23.  
  24.  
  25.                          METHOD OF PAYMENT (check one)
  26.  
  27.         Visa ___      Mastercard ___      Check ___      Money Order ___
  28.  
  29.         Card Number:  ______-______-______-______   Expiration:  ___/___
  30.  
  31.         Name as it appears on card:  ___________________________________
  32.  
  33.         Carholder's Signature:  ________________________________________
  34.  
  35.  
  36.                      comTAP OPTIONS (check one of each)
  37.  
  38.              Media:  5.25" ___       Shells:  XT ___
  39.                                               AT ___
  40.                      3.5"  ___              Both ___  (Add $25.00)
  41.  
  42.  
  43.         ____ Registered copies of comTAP Version 2.1x............$169.00
  44.         ____ Upgrade to MicroTAP (see MICROTAP.DOC)..............$130.00
  45.         comTAP User's Reference (typeset and bound)................incl.
  46.         Two DB-25 or DE-9 connector shells.........................incl.
  47.         RS-232 Modulink monitor cable..............................incl.
  48.         ____ Extra Connector Sets (Add $25.00 per set)...........$___.__
  49.         SUBTOTAL.................................................$___.__
  50.         Tax (California residents add 8.25%).................... $___.__
  51.         Shipping and Handling (call for foreign rates)...........$  8.50
  52.  
  53.         TOTAL....................................................$___.__
  54.  
  55.  
  56.                   REMIT TO:  Paladin Software, Inc.
  57.                              3945 Kenosha Avenue
  58.                              San Diego, CA  92117
  59.                              Tel: (619) 490-0368
  60.                              FAX: (619) 490-0177
  61.