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Text File  |  1995-12-08  |  2KB  |  63 lines
  1. Complete this form to order additional Edge Interactive Publishing, Inc. 
  2. disks by mail.
  3.  
  4. Name_________________________________________________
  5. Address________________________________________________
  6. City __________________ State __________________  Zip __________
  7. Telephone (optional; helps track order problems)________________
  8. E-mail________________________________
  9. Computer type and CD-ROM drive speed_________________________ 
  10.  
  11. I,_______________,(print name) certify that I am over 21 years of age.
  12.  
  13. Signature:___________________________
  14.  
  15. __ YES, send me announcements of upcoming Edge Interactive
  16. Publishing, Inc.products. I understand there is no purchase required.
  17.  
  18. __ YES, please send me additional Edge Interactive Publishing, Inc.
  19. products. I have certified that I am over 21 years of age.
  20.  
  21. Description        Quantity       Amount Each    Subtototal
  22.  
  23. Eric Kroll:FETISH    ________    $49.95        __________
  24.  
  25. Kim Fielding:SHOCK
  26. TACTICS            ________    $49.95        __________
  27.  
  28. Pauliina Raitosola:
  29. PHO-TOY            ________    $49.95        __________
  30.         
  31.  
  32. Steve Bonge:        
  33. TATTOO            ________    $49.95        __________
  34.  
  35.  
  36. Subtotal................................................_________
  37.  
  38.  
  39. NY Residents add 8.25% sales tax.........................________
  40.  
  41.  
  42. Shipping and handling....................................$5.00
  43.  
  44.  
  45. Total....................................................._______
  46.  
  47.  
  48. PAYMENT INFORMATION
  49.  
  50. __ Payment by check or money order made out to:
  51. Edge Interactive Publishing, Inc. is enclosed.
  52.  
  53. __ Please charge my  __ MC  __VISA    
  54.  
  55. Card Number:_________________________________Exp._______
  56.  
  57. Signature_______________________________________________
  58.  
  59. Mail Order Form (and check) to:
  60. Edge Interactive Publishing, Inc.
  61. P.O. Box 20029
  62. Columbus Circle Station
  63. New York, NY 10023-1482