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Text File  |  1994-12-22  |  2KB  |  41 lines
  1.                                 ORDER FORM
  2.                                 ==========
  3.  
  4.     Name ______________________________________________________________
  5.     Company(if applicable) ____________________________________________
  6.     Address ___________________________________________________________
  7.     City/Province ____________________ State _________ Zip ____________
  8.     Country (if outside US) ___________________________________________
  9.     Phone Number (optional) __________________
  10.     FAX Number   (optional) __________________
  11.  
  12.     Internet Address __________________________________________________
  13.  
  14.     Place Where You Found Program _____________________________________
  15.  
  16.     Additional Comments/Suggestions: __________________________________
  17.     ___________________________________________________________________
  18.     ___________________________________________________________________
  19.     ___________________________________________________________________
  20.  
  21.     ┌────┬────────────────────────────────────┬───────┬────────────┐
  22.     │Qty.│Product                             │ Price │Qty. x Price│
  23.     ├────┼────────────────────────────────────┼───────┼────────────┤
  24.     │____│NoteMan/2                           │$10.00 │$________.00│
  25.     │____│QuoteMan/2                          │$10.00 │$________.00│
  26.     │____│BMPMan/2                            │$10.00 │$________.00│
  27.     │____│IconMan/2                           │$10.00 │$________.00│
  28.     │____│INFMan/2                            │$10.00 │$________.00│
  29.     │____│StatsMan/2                          │$10.00 │$________.00│
  30.     │____│Hangman                             │$10.00 │$________.00│
  31.     │____│Other: ____________________________ │$10.00 │$________.00│
  32.     └────┴──────────────────────────────┬─────┴───────┼────────────┤
  33.     (Payment must be in U.S. funds)     │ Grand Total │$________.00│
  34.                                         └─────────────┴────────────┘
  35.  
  36.     Mail to:  Everett Barnes
  37.               2430 Erie Drive
  38.               Concord, CA 94519
  39.  
  40.                         === I appreciate your support! ===
  41.