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 / person / grocer34.zip / ORDER.FRM < prev    next >
Text File  |  1992-08-24  |  878b  |  25 lines
  1.          Invoice Code: Sztyz+Fienfx
  2.  
  3.          Please add me as a supporter of THE GROCER, version 3.3a:
  4.  
  5.  
  6.     Name    ______________________________________________________________
  7.  
  8.     Company ______________________________________________________________
  9.  
  10.     Address ______________________________________________________________
  11.  
  12.             ______________________________________________________________
  13.  
  14.     City    ________________________________State _______ Zip ____________
  15.  
  16.  
  17.     Amount  $12.50_x____copies_=_________________   Date   _______________
  18.  
  19.  
  20.    
  21.                                                       Please Mail To:
  22.  
  23.                                                       Richard Zakas
  24.                                                       119 Hubinger St.
  25.                                                       New Haven,  CT  06511