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/ Fifth Dimension / Fifth Dimension CD-ROM Volume 1 (Data Express) (1995).iso / inst / wq20b.exe / ORDER.FRM < prev    next >
Text File  |  1994-01-27  |  1KB  |  40 lines
  1.                            World Quest Order Form
  2.                      (Canada)
  3.         ------------------------------------------------
  4.  
  5. Name:________________________________________________________________________
  6.  
  7. Address:_____________________________________________________________________
  8.  
  9. City/State:__________________________________________________________________
  10.  
  11. Postal/ZIP Code:_____________________________________________________________
  12.  
  13. Country:_____________________________________________________________________
  14.  
  15. Home Phone # : (___)___-____            Business Phone # : (___)___-____
  16.  
  17. Disks are 1.44 meg 3.5" unless requested otherwise.
  18.  
  19. BBS obtained from (if any):________________________________________________
  20.  
  21.  
  22. Cost:              _____________$35.00
  23.  
  24. Add $2.50 for postage: +_____________$2.50
  25.  
  26. Amount Enclosed:       _____________$37.50
  27.  
  28.  
  29. Amounts shown are for Canadian funds.
  30.  
  31. Make cheque or money order payable to:
  32.          Chris Egerter
  33.          94 Andover Drive
  34.          London, Ontario, CANADA
  35.          N6J 3X2
  36.  
  37.  
  38. ---------------------------------------------------------------------------
  39. Comments:
  40.