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orderfrm.txt
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1993-07-02
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3KB
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49 lines
ACCIDENTAL SOFTWARE
13245 SKIOMAH RD.
APPLE VALLEY, CA. 92307 ASP CD-ROM 07/01/93
-----------------------------------------------------------------
| NAME : ___________________________ |
| ADDRESS : ___________________________ |
| " : ___________________________ |
| " : ___________________________ |
| TODAYS DATE : ___________________________ |
-----------------------------------------------------------------
REGISTER
-----------------------------------------------------------------
| ULTIMATE BLACKJACK PURCHASE & REGISTRATION REQUEST |
| |
| SEND ME THE CURRENT VERSION OF ULTIMATE BLACKJACK ON DISK. |
| |
| ULTIMATE BLACKJACK $10.00 x ( ) $___________ |
| |
| SOUND BLASTER VOICE PACK $ 5.00 x ( ) $___________ |
| |
| SHIPPING AND HANDLING $ 3.00 $ 3.00 |
| |
| Total the amounts and enclose TOTAL $___________ |
| a check or money order as payment. |
| |
| FOREIGN ORDERS: Please use an international money order |
| and specify only U.S. currency. |
| _____ 360k 5 1/4 DISK |
| _____ 1.20 5 1/4 DISK |
| _____ 720k 3 1/2 DISK |
| _____ 1.44 3 1/2 DISK |
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SURVEY
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| SHAREWARE SURVEY |
| |
| How did this product come to your attention? |
| |
| ____ A. From a shareware vendor (name) _____________________ |
| ____ B. From a BBS (name) __________________________________ |
| ____ C. From a friend |
| ____ D. Other (please specify ______________________________ |
| |
| ------------------------------------------------------------ |
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THANKS