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Text File  |  1993-04-04  |  3KB  |  66 lines

  1.                         ***************************
  2.                         * PIPX PRODUCT ORDER FORM *
  3.                         ***************************
  4.  
  5.    QTY       PRODUCT                               PRICE EA       TOTAL
  6.   _______________________________________________________________________
  7.  
  8.   _____   PIPX - Driver Software Only               $69.95       ________
  9.  
  10.   _____   PIPX - Driver Software W/CABLE            $89.95       ________
  11.  
  12.              Select:  ___ 4BIT Cable
  13.                       ___ 8BIT Cable
  14.  
  15.   _____   Parallel Port TurboCable                 $149.95       ________
  16.              Universal High Speed Parallel Cable
  17.              Supports 4BIT, 8BIT, EPP
  18.              Transfer rate to 800 Kbytes/sec
  19.              Includes 2 6ft M-M Cables
  20.  
  21.   _____   4-BIT CABLE Only                          $29.95       ________
  22.  
  23.   _____   8-BIT CABLE Only                          $29.95       ________
  24.  
  25.                  Shipping and Handling (Domestic UPS Ground):       $5.00
  26.            (Call for Alternative shipping or foreign quotes)
  27.  
  28.                      Washington Residents Add 8.2% Sales Tax:    ________
  29.  
  30.                  (COD Shipments - ADD $3.00 Handling Charge):    ________
  31.  
  32.                                                  Total Order:    ________
  33.  
  34.           Inquire regarding Site Licenses and Volume Discounts
  35.  
  36. ********************************************************************************
  37.  
  38. Payment Method (Check One): Check:____ COD:____ VisaCard:____  Mastercard:____
  39.  
  40.  
  41. Ship To:                                 Credit Card Information:
  42.  
  43. _____________________________________    _______________________________________
  44.           (Name)                                (Name - As Shown on Card)
  45.  
  46. _____________________________________    _______________________________________
  47.          (Company)                         (Signature - Required for Charges)
  48.  
  49. _____________________________________    _______________________________________
  50.          (Shipping Address)              (Visa/Mastercard #)   (Expiration Date)
  51.  
  52. _____________________________________    _______________________________________
  53.          (Shipping Address)                           (Address)
  54.  
  55. _____________________________________    _______________________________________
  56.  (City)              (State)   (Zip)      (City)              (State)   (Zip)
  57.  
  58. _____________________________________    _______________________________________
  59.  (Telephone #)       (FAX #)
  60.  
  61. ********************************************************************************
  62.  
  63. FAX OR MAIL TO:  Parallel Technologies, Inc.           Tel: (206) 869-1136
  64.                  P.O Box 7                             Fax: (206) 869-9767
  65.                  Redmond, WA  98073-0007
  66.