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Monster Media 1994 #1
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CREDIT.FRM
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Text File
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1994-03-12
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8KB
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128 lines
Ordering From Duke Graphics:
Through an arrangement with Duke Graphics, you can charge the registration
fee of Southeastern DataLINK products to your Visa, MasterCard, or American
Express card. You can order online via their BBS, or send your order in
the mail with the form that appears below.
ORDERING:
TO ORDER BY MODEM, call Online Resource at (619) 793-8360 and use the
on-line registration system, available from the main menu.
TO ORDER BY MAIL, complete the attached form and mail to:
Duke Graphics
4130 La Jolla Village Drive
Suite 107-169
La Jolla, CA 92037-1480
DUKE GRAPHICS ORDER FORM FORM: 03/94 PAGE 1
┌─────────────────────────────┐
│ Duke Graphics │▐
│ 4130 La Jolla Village Drive │▐
│ Suite 107-169 │▐
│ La Jolla, CA 92037-1480 │▐
│ (619) 736-2614 Voice │▐
│ (619) 793-8360 Data │▐
└─────────────────────────────┘▐
▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀
┌─[ INSTRUCTIONS ]─────────────────────────────────────────────────────────┐
│ ■ Please complete this form in its entirety from top to bottom. │
│ ■ Please type or print LEGIBLY. If possible, edit an electronic version │
│ of this form and upload to Online Resource at (619) 793-8360 using the │
│ file name format of <LASTNAME>.FRM such as DUKE.FRM or HAMILTON.FRM. │
└──────────────────────────────────────────────────────────────────────────┘
┌─[ PERSONAL INFORMATION ]─────────────────────────────────────────────────┐
│ │
│ Company Name___________________________________________________________ │
│ (If not a company, use name of BBS) │
│ │
│ BBS Name_______________________________________________________________ │
│ (If different from "Company Name") │
│ │
│ Contact________________________________________________________________ │
│ (Use your real name: FIRST LAST, i.e. JOHN DOE) │
│ │
│ Title____________________________________ or [_] System Operator (SysOp) │
│ │
│ Voice Phone (_____)_____-______ Data Phone (_____)_____-______ │
│ │
│ Fax Phone (_____)_____-______ Data Phone 2 (_____)_____-______ │
│ │
│ Street_________________________________________________________________ │
│ │
│ Suite/PO Box/Apt/Rt/MS_________________________________________________ │
│ │
│ City____________________________ State/Province________________________ │
│ │
│ Postal Code_______________ Country: [_]USA [_]CANADA [_]OTHER__________ │
│ │
│ Referred By: [_]Hamilton TeleGraphics [_]Friend [_]Sysop │
│ [_]Boardwatch [_]ComputorEdge [_]Other_____________ │
└──────────────────────────────────────────────────────────────────────────┘
┌─[ NETWORK INFORMATION ]──────────────────────────────────────────────────┐
│ │
│ Fidonet____:______/_________ Internet Address___________________________ │
│ │
│ CompuServe________,_________ America On-line____________________________ │
│ │
│ Other 1_____________________________ Other 2____________________________ │
└──────────────────────────────────────────────────────────────────────────┘
DUKE GRAPHICS ORDER FORM FORM: 03/94 PAGE 2
┌─[ ORDER PAYMENT INFORMATION ]────────────────────────────────────────────┐
│ Select Form of Payment │
│ │
│ [_]Visa [_]MasterCard [_]American Express [_]Diner's Club │
│ [_]JCB [_]Carte Blanche │
│ [_]Check Enclosed° [_]Money Order Enclosed │
│ │
│ °If paying by check, please allow up to 5 business days for your │
│ check to clear. To expedite process, pay by money order. │
│ │
├─[ COMPLETE THIS SECTION ONLY IF PAID BY CREDIT CARD ]────────────────────┤
│ │
│ Name on Card____________________________________________________________ │
│ (If not your credit card, state what relation cardholder is to you and │
│ provide cardholder's voice number for verification in space below) │
│ │
│ ________________________________________________________________________ │
│ │
│ Credit Card Number______________________________________________________ │
│ │
│ Expiration Date_________________________________________________________ │
│ │
│ Signature (If this form is sent by mail)________________________________ │
└──────────────────────────────────────────────────────────────────────────┘
┌─[ FOR OFFICE USE ONLY ]──────────────────────────────────────────────────┐
│ │
│ Charged $___.___ on ___/___/___ Approval #__________________________ │
└──────────────────────────────────────────────────────────────────────────┘
┌─[ ITEMS WHICH INCLUDE S&H ]────────────────────┬────┬──┬────┬────────────┐
│ │ │ │ │ │
│ ITEM │VER │ │COST│ QTY TOTAL │
│ │ │ │ │ │
│ BFE, BBS Front End System (Enhanced Release) │3.10│ │$ 45│ ___ _____ │
│ BFE, BBS Front End System (Standard Release) │3.10│ │$ 20│ ___ _____ │
│ IPOST, Internet Mail Posting Door │1.00│ │$ 15│ ___ _____ │
│ VID, Virus Information Door │1.00│ │$ 15│ ___ _____ │
│ └────┘ └────┘ │
├─[ TOTALS / TAX ]─────────────────────────────────────────────────────────┤
│ │
│ SUB-TOTAL _____ │
│ │
│ Sales Tax (in California only) 7.75% (SUB-TOTAL * .0775) _____ │
│ │
│ TOTAL _____ │
└──────────────────────────────────────────────────────────────────────────┘
All sales are final - please evaluate Shareware products prior to purchase
Thank you for your order!