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Text File  |  1994-02-18  |  1KB  |  47 lines
  1.  
  2.                             Shadowland Software
  3.             SPECIAL SERVICES ORDER FORM
  4.  
  5. Name:___________________________________________________________
  6.  
  7. Mailing Address:________________________________________________
  8.  
  9. City:______________________  State:_____  Zip:__________
  10.  
  11. Voice Phone #(OPTIONAL):(     )__________________
  12.  
  13. Item # of item/s ordered:
  14.  
  15. ________     _______  _______  ________   ________  ________  ________
  16.  
  17. Qty.___      Qty.___   Qty.___  Qty.___    Qty.___  Qty.___   Qty.___
  18.  
  19.  
  20. Total Amount Enlosed:$_________   Method Used: [  ] Check  [   ] Money Order
  21.  
  22. Check/M.O. #:_______
  23.  
  24.  
  25. Signature:X____________________________________
  26.  
  27.  
  28.     Mail entire form, with payment to:
  29.  
  30.             Shadowland Software
  31.             P.O. Box 205
  32.             Egg Harbor City, NJ, 08215-0205
  33.  
  34. Allow 4-5 weeks for delivery.
  35.  
  36.  
  37. ==================== FOR OFFICE USE ONLY ===================================
  38.  
  39. Date Rec'd:__________  Date Sent:________    Amount Rec'd$_________
  40.  
  41. Check/MO #:______   Check Banked:__________    
  42.  
  43. Item # Ordered:_____________________________________________________
  44.  
  45. Date Filed:__________   Customer Service #:__________  
  46.  
  47.