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Text File  |  1996-09-01  |  3KB  |  69 lines
  1.                  ----------------------------------
  2.                  Stable Technical Graphs Order Form
  3.                  ----------------------------------
  4. To purchase a licensed version of Stable Technical Graphs, please
  5. fill out and return this registration form along with your check,
  6. postal money order (drawn on U.S. FUNDS ONLY please), or credit 
  7. card information with signature, and mail, call, or send fax to:
  8.  
  9.                    WINTERRA Software Group, Inc.
  10.                    P.O.Box 4106
  11.                    Highlands Ranch, CO 80126-0100
  12.                    USA
  13.                     
  14.                    Voice/Fax: (303)-470-6323
  15.                    Email: product-info@winterra.com
  16.                    http://www.winterra.com
  17.  
  18. ===================================================================
  19.  
  20.    Name: __________________________________________________________
  21.            
  22. Company: __________________________________________________________
  23.  
  24. Address: __________________________________________________________
  25.  
  26. Address: __________________________________________________________
  27.  
  28.    City: ______________________  State: _____  Zip/Postal: ________
  29.  
  30.   Phone: (______)____________________  Fax: (______)_______________
  31.  
  32.   Email: _______________________________
  33.  
  34.  
  35. Quantity: [__]  Stable Technical Graphs      @$49.95  $____________
  36.  
  37.                 Shipping/Handling/Customs
  38.           [__]  U.S.                         @$ 4.00  $____________
  39.           [__]  International                @$10.00  $____________
  40.  
  41.                                                TOTAL  $____________
  42.  
  43. * Product is delivered on 3.5" high-density floppy diskette
  44. ===================================================================
  45.  
  46.       Method of Payment: [___] Check  [___] Credit Card
  47.  
  48. Credit Card Information: [___] Visa   [___] Mastercard
  49.  
  50.         Card Number: ___________________________________
  51.  
  52.        Name on Card: ___________________________________
  53.  
  54.     Expiration Date: ___________________________________
  55.  
  56.           Signature: ___________________________________
  57.  
  58. * Cardholder's billing address (if different than above):
  59.  
  60.    Name: __________________________________________________________
  61.            
  62. Company: __________________________________________________________
  63.  
  64. Address: __________________________________________________________
  65.  
  66.    City: __________________________  State: ______  Zip: __________
  67. ===================================================================
  68. SW2309609
  69.