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Text File  |  1992-12-16  |  2KB  |  50 lines
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  2.  
  3. Remit to:  MAILbase                              Order Form  #9212-CS
  4.            3074 Lancaster Dr. NE Ste 222
  5.            Salem, OR 97305-1349
  6.  
  7.                           Mbase version 2.60
  8.  
  9.       You can use this handy order form to order by MAIL, or by:
  10.  
  11.            Voice:       (503) 393-1564
  12.            COMPUSERVE:  72707,523
  13.  
  14. --------------------------------------------------------------------------
  15. Please SHIP me   
  16.  
  17. ____ Mbase v2.60   with Printed Manual..........  @ $95.00 ea  $ ______
  18.      Includes licensed copy of library (Version 2.60)
  19.      with limited warranty, printed indexed manual,
  20.      registration card, low-cost upgrades.
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  23. SHIPPING (each copy)... US/Canada/Mexico: $5;  Overseas: $10   $ ______
  24. C.O.D.                                        (U.S. only) $4
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  26.                          TOTAL (U.S. Funds drawn on U.S. Bank) $ ______
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  28.                                              
  29. Payment by:  ( )CHECK  ( )MONEY ORDER  (  )CASHIERS CHECK  ( )COD
  30.  
  31. Name: _____________________________________________________________
  32.  
  33. Company (ONLY if company address):_________________________________
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  35. Address: __________________________________________________________
  36.  
  37.        : __________________________________________________________
  38.  
  39.        : __________________________________________________________
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  41. Voice Day Phone: ______________________ Evening: __________________
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  45. Card #: _________________________________ Exp. Date: ______________
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  47. Signature of cardholder: __________________________________________
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