home *** CD-ROM | disk | FTP | other *** search
/ Wayzata's Best of Shareware PC/Windows 2 / Wayzata's Best of Shareware 2.0 (Windows) (Wayzata Technology)(7112)(1994).bin / mac / WINDOWS / GRAPHICS / WINJP160 / ORDER.FRM < prev    next >
Text File  |  1992-11-15  |  2KB  |  43 lines
  1.  
  2.                             WINJPEG ORDER FORM
  3.  
  4.     Name    ___________________________________________________________
  5.  
  6.     Address ___________________________________________________________
  7.  
  8.     City    __________________________ State _________ ZIP ____________
  9.  
  10.     Country (if outside US) ___________________________________________
  11.  
  12.     Phone Number (optional) __________________  Circle:  home  or  work
  13.  
  14.     Email Address (optional) __________________________________________
  15.  
  16.     Circle Type of Email Address:  Internet  or  Compuserve
  17.  
  18.     Shipping (check one):  __  E-mail (no additional charge)
  19.                            __  US residents (add $3)
  20.                            __  Non-US residents (add $8)
  21.  
  22.     Choose Disk Size (check one if you did not select "E-mail" above):
  23.                      __  4  5 1/4" DS/DD (360K) disks
  24.                      __  2  3 1/2" DS/DD (720K) disks
  25.                      __  1  3 1/2" DS/HD (1.44 Mb) disk
  26.  
  27.  
  28.       
  29.   WinJPEG Registration Fee  ($20.00)                                ______
  30.   WinJPEG Update Fee from any registered version  ($5.00)           ______                   
  31.   5% Sales Tax (MA residents only)                                  ______
  32.   Shipping                                                          ______
  33.  
  34.   Total Enclosed                                                    ______
  35.  
  36.  
  37.  
  38.  Mail to:  Norman Yee             Internet Address: nyee@osiris.ee.tufts.edu
  39.            58 Chandler St.                          kenyee@ksr.com
  40.            Boston, MA 02116
  41.  
  42.                      *** Thank you for your order! ***
  43.