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Text File  |  1996-11-18  |  5KB  |  62 lines
  1. ----------------------------------------------------------------------------
  2.  
  3.             ╔═══════════════════════════════════════════════╗
  4.             ║  Order/Registration Form for library PGRAPH2  ║
  5.             ╚═══════════════════════════════════════════════╝
  6.  
  7. ┌──────────────────────────────────────────────────────────────────────────┐
  8. │                                                                          │
  9. │     Name: ______________________________________  Date: _______________  │
  10. │                                                                          │
  11. │  Address: _____________________________________________________________  │
  12. │                                                                          │
  13. │           _____________________________________________________________  │
  14. │                                                                          │
  15. │           _____________________________________________________________  │
  16. │                                                                          │
  17. │   e-mail: _____________________________________________________________  │
  18. └──────────────────────────────────────────────────────────────────────────┘
  19. ┌──────────────────────────────────────────────────────────────────────────┐
  20. │                                                                          │
  21. │  Single-user copy with disk                  ___ x  $14.90 US  ________  │
  22. │                                                                          │
  23. │  Each additional user without disk           ___ x   $3.90 US  ________  │
  24. │                                                                          │
  25. │  Maximum charge                                     $99.90 US  ________  │
  26. │                                                                          │
  27. │  Shipping outside Europe                             $8.50 US  ________  │
  28. │  Shipping inside Europe                              $4.50 US  ________  │
  29. │                                                                          │
  30. │                                                                          │
  31. │  Total                                                   $ US  ________  │
  32. │                                                                          │
  33. │                                                                          │
  34. │  Diskette size        ( ) 5.25"        ( ) 3.5"                          │
  35. └──────────────────────────────────────────────────────────────────────────┘
  36. ----------------------------------------------------------------------------
  37. ┌──────────────────────────────────────────────────────────────────────────┐
  38. │                                                                          │
  39. │  Orders are usually sent the day after receipt, by first class mail.     │
  40. │                                                                          │
  41. │  The following payments are acceptable:                                  │
  42. │                                                                          │
  43. │                                  ┌──────────────────────────┐            │
  44. │  ■ bank transfer to the account: │ No. 194811640237/0100    │            │
  45. │                                  │ Komercni banka a.s       │            │
  46. │                                  │ pobocka Blansko          │            │
  47. │                                  │         nam. Republiky 3 │            │
  48. │                                  │         678 14 Blansko   │            │
  49. │                                  └──────────────────────────┘            │
  50. │                                                                          │
  51. │  ■ check mailed to the address:  ┌───────────────────┐                   │
  52. │                                  │ Miroslav Dressler │                   │
  53. │  ■ cash  mailed to the address:  │ Jiraskova 138     │                   │
  54. │                                  │ Rajec-Jestrebi    │                   │
  55. │                                  │ 679 02            │                   │
  56. │                                  │ Czech Republic    │                   │
  57. │                                  └───────────────────┘                   │
  58. │                                                                          │
  59. │  Note: cash is not recommended (it is somewhat unsafe for sender).       │
  60. │  If you send cash, please use registered mail.                           │
  61. └──────────────────────────────────────────────────────────────────────────┘
  62.