home *** CD-ROM | disk | FTP | other *** search
/ Kids Cube / 6_Math.iso / addalotm / order.frm < prev    next >
Text File  |  1993-08-23  |  1KB  |  38 lines

  1.           Order Form for Landmark Solutions
  2.  
  3. Your system is a 386SX or faster with 
  4. VGA graphics, hard disk, and 640Kb memory, Yes_______  No_______
  5. Note:If you checked No, the game will not work with the system
  6.  
  7. Name:   _____________________________________________________
  8.                              
  9. Address:_____________________________________________________
  10.      
  11.         _____________________________________________________
  12.  
  13. City:   _____________________________________________________
  14.  
  15. State:  _________________ Zip:_______________________________
  16. Phone 
  17. Number:  ( ______ ) ________ - ____________
  18.  
  19. Disk Size   3.5"________  5.25"__________
  20.         
  21. ----------------------------------------------------------------
  22.                                    Quantity             Total  
  23. ----------------------------------------------------------------
  24.      
  25. Sir AddaLot's Math Adventure       ________ X $19.95 = ________
  26.  
  27.                          IN residents add 5% Sales Tax ________
  28.  
  29.                                                  TOTAL ________
  30.  
  31. Method of payment:      
  32. [ ] Check or money order made payable to Landmark Solutions, Inc.
  33. [ ] VISA     [ ] MasterCard    
  34.      
  35. Card No:__________________________________ Expires:______________
  36.      
  37. Thank You For Registering!!
  38.