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Text File  |  1995-02-28  |  3KB  |  53 lines
  1.  
  2.  
  3.                        ----------------------------------
  4.                                HOMEDATA Order Form
  5.                        ----------------------------------
  6.  
  7.         To order and register HOMEDATA, please fill out the form below. 
  8.  
  9.                                                       Date: _____________
  10.  
  11.         Name: _______________________________________ ___________________
  12.  
  13.         Address: ________________________________________________________
  14.  
  15.         City: ___________________________________________________________
  16.  
  17.         State/Country: ________________________ Zip: ____________________
  18.  
  19.  
  20.         Method of payment: Please complete the worksheet below. Virginia
  21.         State residents must add sales tax. ALL CHECKS AND MONEY ORDERS
  22.         MUST BE DRAWN ON U.S. ACCOUNTS ONLY.
  23.  
  24.  
  25.         +----------+------------------------------+----------+----------+
  26.         |          |                              |   Cost   |   Total  |
  27.         | Quantity |          Description         | per unit |   Cost   |
  28.         +==========+==============================+==========+==========+
  29.         |          |                              |          |          |
  30.         |          | HomeData Software Package    |  $30.00  |          |
  31.         |          | Version 2.1                  |          |          |
  32.         +==========+==============================+==========+==========+
  33.         |                                                    |          |
  34.         | Shipping and Handling                              |   2.50   |
  35.         |                                                    |          |
  36.         +----------------------------------------------------+==========+
  37.         |                                                    |          |
  38.         | Virginia Residents, please add $1.35 sales tax     |          |
  39.         |                                                    |          |
  40.         +----------------------------------------------------+==========+
  41.         |                                                    |          |
  42.         | Size of Disk desired  ___ 5.25" ___ 3.5"    TOTAL  |          |
  43.         |                                                    |          |
  44.         +----------------------------------------------------+==========+
  45.  
  46.         Where did you learn about HomeData?______________________________
  47.  
  48.         *****************************************************************
  49.         Send this registration to:    Advanced Data Solutions
  50.                                       P.O. Box 714        
  51.                                       Luray, Va 22835 USA
  52.         *****************************************************************
  53.