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Text File  |  1996-04-27  |  3KB  |  61 lines
  1.                      Danger Of Death Mail Order Form
  2.  
  3. Please read this document carefully!
  4.  
  5. Name (Please Print) ________________________________________________________
  6. Address ____________________________________________________________________
  7. City _________________________ State/Province ______________________________ 
  8. ZIP/POSTAL CODE ___________________ Country  _______________________________ 
  9. Phone/Fax __________________________________________________________________
  10. E-Mail _____________________________________________________________________
  11.  
  12. Signature:   ________________________________________   *** Thank you! ***
  13.  
  14. PRODUCT                                                 PRICE IN £ STERLING
  15.  
  16. [ ] ATOMS FOR WINDOWS 3.5" (Registered)                 £8.50
  17. [ ] MEMOS FOR WINDOWS 3.5" (PD)                         £1.00
  18. [ ] GAMES MUSIC EXTRACTION KIT 3.5" (PD)                £1.00
  19.  
  20. SHIPPING CHARGES:             |TOTALS:
  21. [ ] UK                 £1.50  |Shipping and Handling charges: £______________
  22. [ ] All other countries   £3  |                    Sub-Total: £______________                 
  23. [ ] E-Mail             £0.20  |              Amount enclosed: £______________
  24.  
  25. Important: We only accept Internation Money Orders/UK Postal Money Orders!
  26.  
  27. Questionaire____________
  28.  
  29. Where did you get this program from:
  30.  
  31. Downloaded from:
  32. [ ]        BBS: Name: _____________________________________________________
  33. [ ]        CompuServe (CIS): Forum Name: ___________________________________
  34. [ ]        America Online (AOL)
  35. [ ]        Genie: RoundTable  (RT) Name: ___________________________________ 
  36. [ ]        Delphi: Special Interest Group (SIG) Name: ______________________
  37. [ ]        Internet FTP Site: Site Name: ___________________________________
  38.  
  39. Purchased from:
  40. [ ]        Catalog Vendor: Vendor Name: ____________________________________
  41. [ ]        Retail (Store, flea market, computer fair): 
  42.                                 Vendor Name:  ______________________________
  43. [ ]        Ordered it from us
  44.  
  45. Other:
  46. [ ]        A friend gave it to me
  47. [ ]        None of the above
  48. [ ]        Unknown
  49.  
  50. O_/__C_U_T__H_E_R_E___________________________________________________________________
  51. O_\__C_U_T__H_E_R_E___________________________________________________________________
  52.  
  53. Make orders payable to "Robert Parratt".
  54. Orders mailed to our UK address must be drawn in Pounds Sterling.
  55. Please allow a_t__l_e_a_s_t__2_8__d_a_y_s_ for delivery.
  56.  
  57. Mail to: Danger Of Death,
  58.          13, Stream valley Road,
  59.          GU10 3LT
  60.          England
  61.