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Text File  |  1995-05-14  |  1KB  |  41 lines
  1. Use for credit card orders only! Send, fax or email to:
  2.  
  3. Public (software) Library    Phone: 713-524-6394
  4. P.O. Box 35705            Fax:   713-524-6398
  5. Houston, TX 77235-5705        CIS:   71355,470
  6. USA
  7.  
  8.  
  9.  
  10. Name:_______________________________________________________________
  11.  
  12. Address:____________________________________________________________
  13.  
  14. City:___________________________________ State:______ ZIP:__________
  15.  
  16. Country:____________________________________________________________
  17.  
  18. Phone:_____________________________ Fax:____________________________
  19.  
  20. EMail:_____________________________ (use if you want to save s&h!!)
  21.  
  22.  
  23. YES! I would like to purchase my personal registration number
  24. for Dave Dude 95, Release 2, item/product #11997:
  25.  
  26. Registration# for Dave Dude 95, Release 2............ $(US)   18.00
  27.  
  28. Shipping and handling (worldwide) ................... $(US) _______
  29.     (email $(US) 0.00, air mail $(US) 3.00)
  30.  
  31.                            Total: $(US) _______
  32.  
  33.  
  34. [ ] MasterCard  or  [ ] VISA  or  [ ] AmEx  or  [ ] Discover
  35.  
  36. Card#(16 digits):__ __ __ __  __ __ __ __  __ __ __ __  __ __ __ __ 
  37.  
  38. Expiration Date: __ __ / __ __ Cardholders name: __________________
  39.  
  40. Date: _____________ Cardholders Signature: ________________________
  41.