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Text File  |  1996-01-31  |  2KB  |  51 lines
  1.     ========================================================================
  2.     *** Registration ***         ORDER FORM
  3.     ========================================================================
  4.  
  5.     SEND CHECKS, INQUIRIES, SUGGESTIONS AND COMMENTS TO:
  6.     
  7.         CQ Research Corp         Phone: 604.932.5529
  8.         P.O. Box 1530              FAX: 604.932.5548
  9.         Whistler, B.C. Canada, V0N 1B0
  10.  
  11.         CompuServe........  70621,2170       
  12.         Internet WWW......  http://www.cqr.com
  13.         Internet E-Mail...  register@cqr.com
  14.     
  15.     CREDIT CARD ORDERS: WE ACCEPT ALL VISA CARDS
  16.         
  17.     ORDERED BY: (if paying by credit card,
  18.                  please give address of cardholder)
  19.     
  20.         Name:__________________________________________________________
  21.         Company:_______________________________________________________
  22.         Address:_______________________________________________________
  23.         City:__________________________________________________________
  24.         State:___________  Country__________  Postal Code:_____________
  25.         Phone:_________________________  FAX:__________________________
  26.         E-Mail Address: _______________________________________________
  27.         
  28.     
  29.     PRODUCTS ORDERED:
  30.     
  31.         1) Business Base 2.2 License,                $39.00  __________
  32.     
  33.         2) Shipping: 0 Postal  $8 Courier                    __________
  34.     
  35.         3) 7% GST for Canadian Orders only                   __________
  36.  
  37.         Total Amount (U.S. Dollars)                          $
  38.                                                              ==========
  39.     
  40.     
  41.     METHOD OF PAYMENT:
  42.     
  43.         [ ] Check  [ ] VISA   [ ] Money order
  44.     
  45.         Card Number: __________________________________________________
  46.     
  47.         Expiration Date: ________ Signature: __________________________
  48.     
  49.         Name of Cardholder: ___________________________________________
  50.                     
  51.