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Text File  |  1996-05-01  |  3KB  |  62 lines

  1.  
  2.           Telix version 3.51                                     #960501-351
  3.           ------------------------------------------------------------------
  4.           Remit to: deltaComm Development, PO Box 1185, Cary, NC  27512  USA
  5.           ------------------------------------------------------------------
  6.           Quan       Item                              US/CDN        Price
  7.  
  8.           ___  Telix Registration................   @ $69/$94 ea   $________
  9.                 (includes serial #, registration +
  10.                   program and manual on disk,
  11.                   retail packaging, printed manuals)
  12.  
  13.           ___  Telix Upgrade.....................   @ $29/$39 ea   $________
  14.                 (includes serial #, registration +
  15.                   program and manual on disk,
  16.                   retail packaging, printed manuals)
  17.  
  18.  
  19.           My Telix for DOS 3.22 or prior Serial Number: ____________________
  20.  
  21.           Disk media:  5.25" [  ]     3.5" [  ]     Low Density [  ]
  22.  
  23.                                                  Volume Discount   $(______)
  24.  
  25.           Single Copy Shipping/Handling is:   ------>   Shipping   $________
  26.           USA:           : $10, via Second Day Air
  27.           Canada:        : $10, via Air Mail; $20 Second Day
  28.           Elsewhere:     : $10, via Air Mail, $30 Second Day
  29.  
  30.           Call 800-859-8000 for multiple copy shipping rates
  31.  
  32.                                                         Subtotal   $________
  33.  
  34.            N. Carolina residents please add State Sales Tax (6%)   $________
  35.  
  36.                                                            TOTAL   $________
  37.  
  38.           ------------------------------------------------------------------
  39.           Payment by: ( ) Check or MO  ( ) VISA/MC  ( ) PO # ____________
  40.  
  41.               Name_______________________________________________________
  42.  
  43.            Company_______________________________________________________
  44.  
  45.            Address_______________________________________________________
  46.  
  47.                   _______________________________________________________
  48.  
  49.                       Visa/MC orders will be charged in US currency
  50.               The following information is needed for VISA/MC card payments
  51.  
  52.              Phone(______)________________  Other(______)________________
  53.  
  54.             Card #_______________________________  Expiry date___________
  55.  
  56.           Name of cardholder_____________________________________________
  57.  
  58.           Signature______________________________________________________
  59.                         (VISA/MC orders may also call voice: 800-TLX-8000
  60.                         (VISA/MC orders may also fax:        919-460-4531
  61.  
  62.