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Text File  |  1996-09-03  |  2KB  |  60 lines
  1.     ========================================================================
  2.     *** Licensed Copy ***           ORDER FORM
  3.     ========================================================================
  4.  
  5.     SEND CHECKS, INQUIRIES, SUGGESTIONS AND COMMENTS TO:
  6.  
  7.         BizMark Development         Phone: (318) 949-4399
  8.         P.O. Box 182                FAX:   (318) 949-4400
  9.         Princeton, LA 71067-0182
  10.  
  11.         America Online....  BizMarkDev
  12.         CompuServe........  70262,114
  13.         Internet WWW......  http://www.bizmark.com
  14.         Internet E-Mail...  mhicks@bizmark.com
  15.  
  16.     CREDIT CARD ORDERS ONLY (VISA, Master Card, AmEx, Discover):
  17.  
  18.         Phone:      800-242-4775    CompuServe: 71355,470
  19.         Phone:      713-524-6394    Internet: 71355.470@compuserve.com
  20.         FAX:        713-524-6398
  21.  
  22.         NOTE! Request Product #11665.
  23.         NOTE! Please include the address of the cardholder.
  24.  
  25.     ORDERED BY: (if paying by credit card,
  26.                  please give address of cardholder)
  27.  
  28.         Name:__________________________________________________________
  29.         Company:_______________________________________________________
  30.         Address:_______________________________________________________
  31.         City:__________________________________________________________
  32.         State:___________  Country__________  Postal Code:_____________
  33.         Phone:_________________________  FAX:__________________________
  34.         E-Mail Address: _______________________________________________
  35.  
  36.         Name of Primary User of this Product  (for technical support
  37.           and  security purposes):   __________________________________
  38.  
  39.     PRODUCTS ORDERED:
  40.  
  41.         1) Business Clock Link v2.5 Site License,
  42.            Printed Manager's Guide (manual),
  43.            Technical Support                        $149.00  __________
  44.  
  45.         2) Shipping: $4 USA & Canada, $8 International       __________
  46.  
  47.         Total Amount (U.S. Dollars)                          $
  48.                                                              ==========
  49.     DISKETTE SIZE NEEDED:   ___ 3.5"   ___ 5.25"
  50.  
  51.     METHOD OF PAYMENT:
  52.  
  53.         [ ] Check  [ ] VISA   [ ] MC   [ ] Am Express   [ ] Discover
  54.  
  55.         Card Number: __________________________________________________
  56.  
  57.         Expiration Date: ________ Signature: __________________________
  58.  
  59.         Name of Cardholder: ___________________________________________
  60.