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Text File  |  1992-12-24  |  1KB  |  47 lines
  1.               -= DST version 1.0 C Source Order Form =-
  2.  
  3.  
  4.  
  5. Name:__________________________________________________________________
  6.  
  7. Address:_______________________________________________________________
  8.  
  9. City/Town:_______________________ State/Province:______________________
  10.  
  11. Zip/Postal Code:__________________       Country:______________________
  12.  
  13. Phone Number   : (     )__________          Date:______________________
  14.  
  15.  
  16. Name of BBS where DST was obtained from:
  17.  
  18. ____________________________________________________________________________
  19.  
  20.  
  21. Disk Type      :  [ ] 5 1/4 (360)    [ ] 3 1/2 (720)
  22.  
  23.  
  24. Comments/Suggestions:______________________________________________________
  25.  
  26. ____________________________________________________________________________
  27.  
  28. ____________________________________________________________________________
  29.  
  30.  
  31. U.S. residents send $10.00 in U.S. currency.
  32.  
  33. Canadian residents send $12.00 in Canadian funds.
  34.  
  35. International orders (outside of US & Canada) send $15 in U.S. funds.
  36.  
  37. Amount enclosed:____________________________________
  38.  
  39.  
  40. Make check or money order payable to:  Bits, Bytes & PC's   and mail to:
  41.  
  42.       Bits, Bytes & PC's
  43.       c/o Joseph J Kowalczyk
  44.       11712 Gila dr.
  45.       Kuna Id, 83634-2640
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  47.