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Text File  |  1993-08-18  |  1.8 KB  |  51 lines
  1.                   REMOTEACCESS PROFESSIONAL 2.0
  2.                            Order Form
  3.  
  4.                          (PLEASE PRINT)
  5.  
  6. NAME: ____________________________________________________________________
  7.  
  8. COMPANY NAME: ____________________________________________________________
  9.  
  10. ADDRESS: _________________________________________________________________
  11.  
  12. CITY/STATE/PROVINCE: _____________________________________________________
  13.  
  14. ZIP/POSTAL CODE: _________________________________________________________
  15.  
  16. COUNTRY: _________________________________________________________________
  17.  
  18. DAYTIME PHONE NUMBER: ____________________________________________________
  19.  
  20.                                             * SHAREWARE
  21.                         RETAIL                UPGRADE
  22.                                 QTY                   QTY
  23.      2 NODE VERSION:  $ 149.00 _____        $  99.00 _____ 
  24.     10 NODE VERSION:  $ 269.00 _____        $ 119.00 _____  
  25.    250 NODE VERSION:  $ 529.00 _____        $ 319.00 _____
  26.  
  27.                                            TOTAL: $  _____
  28.  
  29.           * SHAREWARE UPGRADE PRICING EXPIRES 30-OCT-93
  30.  
  31.                        METHOD OF PAYMENT:
  32.          (DO NOT SEND CASH. ALL PRICES ARE IN US FUNDS)
  33.  
  34.                             CHECK ONE
  35.             CHECK: ___  MASTER CARD: ___  VISA: ___  
  36.  
  37.               DISCOVER: ___  AMERICAN EXPRESS: ___ 
  38.  
  39. NAME AS IT APPEARS ON CARD: ______________________________________________
  40. CARD NUMBER: _____________________________________________________________
  41. EXPIRE DATE: _____________________________________________________________
  42.  
  43.  
  44.            RETURN THIS COMPLETED FORM AND PAYMENT TO:
  45.  
  46.                        WANTREE DEVELOPMENT
  47.                        108 WEST 3RD STREET
  48.                   BONNER SPRINGS, KANSAS. 66012
  49.  
  50.  
  51.