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Text File  |  1996-01-18  |  3KB  |  54 lines
  1.              Precision Systems Order Form
  2.  
  3. Name ___________________________________________________________________
  4.  
  5. Address ________________________________________________________________
  6.  
  7. City _____________________________ State _________ ZIP _________________
  8.  
  9. Country (if outside USA) _______________________________________________
  10.  
  11. Phone (optional) ________________________  Circle:  home  or  work
  12.  
  13. Circle disk size:   5 1/4"    3 1/2"    
  14.  
  15.  
  16. NOTE:  Please add $4 for postage and handling.  Outside USA add $2 extra.
  17.  
  18. __ITEM____________Description______________Quantity__Amount___Total_______
  19.      |                               |         |        |
  20. _________|_______________________________|_________|________|_____________           |
  21.      |                               |         |        |
  22. _________|_______________________________|_________|________|_____________           |
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  24. _________|_______________________________|_________|________|_____________           |
  25.      |                               |         |        |
  26. _________|_______________________________|_________|________|_____________           |
  27.      |                               |         |        |
  28. _________|_______________________________|_________|________|_____________           |
  29.      |                               |         |        |
  30. _________|_______________________________|_________|________|_____________           |
  31.      |                               |         |        |
  32. _________|_______________________________|_________|________|_____________           |
  33.      |                               |         |        |
  34. _________|_______________________________|_________|________|_____________           |
  35.      |                               |         |        |
  36. _________|_______________________________|_________|________|_____________           |
  37.      | Shipping & Handling           |         |  4.00  |      4.00
  38. _________|_______________________________|_________|________|_____________           |
  39.                                 |
  40. **********************************************Total:        |_____________
  41.  
  42.  
  43. Mail to:  Precision Systems           Phone: (541) 330-0728
  44.       P.O. Box 7796               BBS:   (541) 389-5404
  45.       Bend, OR 97708              Visa & MasterCard welcome!
  46.  
  47. Check your card:  [] Visa or [] M/Card
  48.  
  49. Card number: ________________________  Expiration date:  _____/_____ (MM/YY)
  50.  
  51. Signature:   _______________________________________   *** Thank you! ***
  52.  
  53. Please make checks payable to "Precision Systems".
  54.