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The Best of Select: Games Special 4
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THE BEST OF SELECT Games Special 4 (Select CD-ROM)(1996).iso
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order.frm
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Text File
|
1992-11-11
|
5KB
|
60 lines
+------------------------------------------------------------------------------+
| Note by Note - Order Form |
| |
| Applied MicroSystems, Inc. Roswell, GA (404) 552-9000 |
+------------------------------------------------------------------------------+
| | Qty. | at | |
| +------+---------------+--------------+
| Note by Note | | $ 59.95 each | $ |
| +------+---------------+--------------+
| sub-total | $ |
| +--------------+
| GA residents please add 6% sales tax | $ |
| +--------------+
| Shipping / handling $5.00 | |
| (not required if pre-paid by check) | $ |
| +--------------+
| TOTAL | $ |
| +--------------+
| |
| Please specify diskette size: ( ) 5¼" ( ) 3½" |
| |
| |
| Mail to: Applied MicroSystems, Inc. |
| Attn: Dept. NW |
| P.O. BOX 832 |
| Roswell, GA 30077 |
| |
| |
| Please make checks payable (in U.S. funds) to Applied MicroSystems, Inc. |
| |
| |
| Method of Payment: ( ) pre-paid by check ( ) Visa ( ) MC ( ) AMEX |
| |
| Credit Card Info: Name:_____________________________________ |
| |
| Acct. No:_____________________________________ |
| |
| Expiration:_____________________________________ |
| |
| Signature:_____________________________________ |
| |
| Ship To: Name:_____________________________________ |
| |
| Company:_____________________________________ |
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| Address:_____________________________________ |
| |
| _____________________________________ |
| |
| City:_____________________________________ |
| |
| State:_____________ Zip:________________ |
| |
| Telephone:_____________________________________ |
| |
| |
+------------------------------------------------------------------------------+