home *** CD-ROM | disk | FTP | other *** search
/ The 640 MEG Shareware Studio 2 / The 640 Meg Shareware Studio CD-ROM Volume II (Data Express)(1993).ISO / compress / dskbs140.zip / ORDERFRM.TXT < prev    next >
Text File  |  1992-11-19  |  2KB  |  88 lines
  1.                              ORDER FORM
  2.  
  3.  
  4. Please complete the following and mail the form and registration
  5. fee to:
  6.  
  7.                            Attn: DiskBase
  8.                              IntelliSys
  9.                             PO BOX 21233
  10.                           Roanoke, VA 24018
  11.  
  12.  
  13. Name: _______________________________________________________________
  14.  
  15. Company: ____________________________________________________________
  16.  
  17. Address: ____________________________________________________________
  18.  
  19.          ____________________________________________________________
  20.  
  21. City, State, Zip: ___________________________________________________
  22.  
  23. Country: ____________________________________________________________
  24.  
  25. Daytime Phone Number: _______________________________________________
  26.  
  27.  
  28.                                          Diskette format (check one):
  29.  
  30.                                        5.25" disk (__) 3.5" disk (__)
  31.  
  32.                                   Number of copies of at $34.95 each:
  33.  
  34.                                           ____ x $34.95 = $_________
  35.  
  36.                                 Shipping & handling for each package:
  37.  
  38.                                    ____ packages x $5.00 = $_________
  39.  
  40.                                            Total enclosed: $_________
  41.  
  42.  
  43.  
  44.                                 TERMS
  45.  
  46. Check or Money Order drawn on a United States bank in United States
  47. funds. All licenses are prepaid only. All orders outside of the
  48. United States must be prepaid.
  49.  
  50.  
  51.  
  52.                             QUESTIONNAIRE
  53.  
  54.  
  55.  
  56. Please complete the following questionnaire.
  57.  
  58.  
  59. Where did you obtain your copy of this program?
  60.  
  61.  
  62.  
  63.  
  64.  
  65.  
  66.  
  67. Which version do you have? __________________________________________
  68.  
  69.  
  70. To help us provide you with the highest quality product possible,
  71. what comments or suggestions do you have about this program or
  72. IntelliSys?
  73.  
  74.  
  75.  
  76.  
  77.  
  78.  
  79.  
  80.  
  81.  
  82.  
  83.  
  84.  
  85.  
  86.  
  87.  
  88.