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Text File  |  1999-03-23  |  2KB  |  71 lines
  1. Software USA - Software Order Form
  2.  
  3. Shipping and Billing information (Please Print)
  4.  
  5. Name
  6.  
  7. ______________________________________________________________
  8.  
  9. Address
  10.  
  11. ______________________________________________________________
  12.  
  13. City/Town
  14.  
  15. ______________________________________________________________
  16.  
  17. State/Province Postal/Zip Code
  18.  
  19. _____________________________ ________________________________
  20.  
  21. Country
  22.  
  23. ______________________________________________________________
  24.  
  25. Phone Number Member #
  26.  
  27. (______)_____________________ _________________________________
  28.  
  29. Payment Methods (Credit Card ONLY)
  30.  
  31. [ ] MasterCard [ ] Visa [ ] American Express [ ] Discover
  32.  
  33. Credit Card Number:______________________________________________
  34.  
  35. Expiration date:______/______/______
  36.  
  37. Signature:______________________________________________________
  38.  
  39. Mail completed form to:
  40.  
  41. Software USA
  42.  
  43. Attn: Software Catalog
  44.  
  45. 9909 Huennekens Street - Suite 200
  46.  
  47. San Diego, CA 92121-2929
  48.  
  49. Software Titles Ordered
  50.  
  51. Quantity - Program Title - Price
  52.  
  53. ________ - ______________________________________________________ - ______________
  54.  
  55. ________ - ______________________________________________________ - ______________
  56.  
  57. ________ - ______________________________________________________ - ______________
  58.  
  59. ________ - ______________________________________________________ - ______________
  60.  
  61. ________ - ______________________________________________________ - ______________
  62.  
  63. ________ - ______________________________________________________ - ______________
  64.  
  65. Subtotal $_____________
  66.  
  67. Sales Tax $____________ (7.75% - CA residents only)
  68.  
  69. Shipping $_____________ [ $3.50 for every two titles ordered ]
  70.  
  71. Total $________________