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Text File  |  1996-06-23  |  3KB  |  61 lines
  1.                       Order Form for agSI Version 1.2.0
  2.                     ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
  3.  
  4.      (please fill in / check:)
  5.                                              prices each    prices total
  6.  
  7.      ___ x Licence for agSI                $ 23 / DM 30,- * ->  __ _____
  8.            (you will recieve a registration code)               ^ currency
  9.  
  10.      ___ x 3 1/2" Disk with latest version  $ 4 / DM  5,- * ->  __ _____
  11.            default English; [ ] also German, [ ] only German
  12.            [ ] I want 5 1/4 " disk(s)
  13.            outside Europe additionally   1x $ 6 / DM  8,-   ->  __ _____
  14.  
  15.      * For discounts on quantity orders, see README or online help!
  16.  
  17.      Payment/Shipping:
  18.      ( )  C.O.D. (only inside Germany!)            DM  5,-  ->  __ _____
  19.      ( )  pre-paid (cash / cheque)                   --             --
  20.      ( )  Credit card [ ] Visa  [ ] Diners Club  [ ] Amer.Express   --
  21.            (Euro-/MasterCard soon! Ask or look at my WWW page)
  22.  
  23.           Card no.: ______________________ Expiration: __________
  24.           Name & address of card owner (if different from below):
  25.  
  26.           _______________________________________________________
  27.  
  28.           _______________________________________________________
  29.                                                              =============
  30.  
  31.      Total:  ------------------------------------------------>  __ _____
  32.  
  33.      [ ]  Inform me about "major" upgrades [ ] via e-mail [ ] via letter
  34.  
  35.      I got agSI from... __________________________________________________
  36.  
  37.      Comments: ___________________________________________________________
  38.  
  39.               ____________________________________________________________
  40.  
  41.      Name:    ____________________________________________________________
  42.  
  43.      Company: ____________________________________________________________
  44.  
  45.      Address: ____________________________________________________________
  46.  
  47.               ____________________________________________________________
  48.  
  49.               ____________________________________________________________
  50.  
  51.      E-Mail:  ____________________________________________________________
  52.      (accessible from the Internet)
  53.  
  54.  
  55.      Date: __________________   Signature: _______________________________
  56.  
  57.      Mail to:  Andreas Groegel           or (C.O.D./credit card) via
  58.                Gildenstr. 4              e-mail (Internet) to:
  59.                D-74074 Heilbronn           ag@studbox.uni-stuttgart.de
  60.                Germany
  61.