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/ The 640 MEG Shareware Studio 2 / The 640 Meg Shareware Studio CD-ROM Volume II (Data Express)(1993).ISO / dbase / cm110.zip / ORDER.FRM < prev   
Text File  |  1992-11-16  |  3KB  |  64 lines
  1. +--------------------------------------+----------------order to---------------+
  2. |                                      |                                       |
  3. |                                      |     HOUSTON COMPUTER SERVICES, INC.   |
  4. |          PRODUCT ORDER FORM          |          3207 Ashfield Drive          |
  5. |          ==================          |     Houston, Texas  77082-2205  USA   |
  6. |                                      | fax:(713)558-1880  voice:(713)493-9900|
  7. |                                      |                                       |
  8. +--------------------------------------+---------------------------------------+
  9.  
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  11.  
  12.                              please enter my order:
  13.  
  14.  
  15.  
  16.       qty    part #           description              price/each      totals
  17.      =====  ========  ============================     ==========   ============
  18.  
  19.   1  _____  ID200H    Cable Master H/W & S/W              $195.00   ____________
  20.  
  21.   2  _____  ________  ____________________________     __________   ____________
  22.  
  23.   3  _____  ________  ____________________________     __________   ____________
  24.  
  25.  
  26.                                                         SUBTOTAL:
  27.   +-------- CREDIT CARD INFORMATION --------+                       ============
  28.   |                                         |
  29.   | __AMEX    __M/C    __VISA    __DISCOVER |
  30.   |                                         |         SHIPPING &
  31.   |  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _  |           HANDLING:           5.00
  32.   |                                         |
  33.   | EXPIRES: ___/___   NAME: ______________ |    COD FEE ($4.00):   ____________
  34.   |                                         |
  35.   | Signature  (required for credit orders) |       (TEXAS ONLY)
  36.   |                                         |    8.25% SALES TAX:   ____________
  37.   |                                         |
  38.   +-----------------------------------------+        ORDER TOTAL:
  39.                                                                     ============
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  45.                                            Ship To:
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  47.  
  48.   NAME:        _________________________________________________________________
  49.  
  50.  
  51.   COMPANY:     _________________________________________________________________
  52.  
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  54.   ADDRESS:     _________________________________________________________________
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  56.  
  57.                _________________________________________________________________
  58.  
  59.  
  60.                _________________________________________________________________
  61.  
  62.  
  63.   PHONE:       ____________________________
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