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Text File  |  1994-02-01  |  2KB  |  60 lines
  1.      ============================
  2.      CREDIT CARD OR PO ORDERS:
  3.       CALL TOLL-FREE 800-707-2558
  4.      ============================
  5.  
  6.                        INVOICE/REGISTRATION FORM
  7.                          PURGECL - VERSION 2.0
  8.  
  9.         For mail orders, please include this form. 
  10.      a) Total number of copies = ___
  11.  
  12.      b) Enter number of copies (2 OR LESS)   ___ x $69.95 = _____ 
  13.  
  14.      c) Enter number of copies (MORE THAN 2) ___ x $19.95 = _____ 
  15.  
  16.      d) Unlimited-use Site License                $495.00 = _____
  17.  
  18.      d)                                          Subtotal = _____
  19.                                                
  20.      e)                 KY residents: add 6% KY sales tax = _____
  21.                                          
  22.      f)                                         Total Due = _____
  23.  
  24.      Please make your check or MO payable to: Blue Ridge Software
  25.      NON-US CUSTOMERS MAY PAY IN CASH (FOREIGN CURRENCY) OR MO
  26.      Mail to:
  27.         Blue Ridge Software, Inc.
  28.         235 Southport Drive
  29.         Lexington, KY  40503
  30.   
  31.      Credit Card Customers:   
  32.      ----------------------        
  33.         VISA / Mastercard / AMEX (circle one)     
  34.  
  35.         Card number: ___________________________ Exp. Date _________
  36.  
  37.         Signature: ________________________________ (Must be signed)
  38.  
  39.      Shipping Address:
  40.      -----------------
  41.      Name:_________________________________________________________
  42.  
  43.      Company name:_________________________________________________
  44.  
  45.      Address:______________________________________________________
  46.  
  47.      City/State/Zip/Country:_______________________________________
  48.      
  49.      Billing Address (if different from shipping address):
  50.      -----------------
  51.      Name:_________________________________________________________
  52.  
  53.      Company name:_________________________________________________
  54.  
  55.      Address:______________________________________________________
  56.  
  57.      City/State/Zip/Country:_______________________________________
  58.  
  59.                          THANKS FOR YOUR ORDER
  60.