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Text File  |  1994-01-10  |  3KB  |  106 lines
  1.                             REGISTRATION/ORDER FORM
  2.  
  3.      ======================================================================
  4.  
  5.      Remit to:   The Software Cobbler
  6.                  P.O. Box 5743
  7.                  Auburn, CA 95604
  8.  
  9.      Ship to:
  10.  
  11.      Name: ________________________________________________________________
  12.  
  13.      Company (if applicable): _____________________________________________
  14.  
  15.      Address: _____________________________________________________________
  16.  
  17.               _____________________________________________________________
  18.  
  19.               _____________________________________________________________
  20.  
  21.                                                              Price
  22.      Qty.   Description                                      each    Amount
  23.  
  24.      _____  Registered version of WordJournal ............. $20.00  $______
  25.  
  26.      _____  Non-shareware version of WordJournal EX ....... $35.00  $______
  27.  
  28.                                                           Subtotal  $______
  29.  
  30.                           California residents add 7.25% sales Tax  $______
  31.  
  32.                                    Shipping & Handling(USA)  $3.00  $______
  33.  
  34.                           Shipping & Handling (outside USA)  $8.00  $______
  35.  
  36.                                                     Total Enclosed  $______
  37.  
  38.      Disk size preferred (check one): [ ] 3.5"  [ ] 5.25"
  39.  
  40.      Payment method:
  41.      ( )Check ( )Money Order
  42.      ( )Visa  ( )MasterCard  ( )American Express
  43.  
  44.      Account Name: __________________________________________
  45.  
  46.      Credit Card #:__________________________________  Exp. Date __________
  47.  
  48.      Signature of cardholder: _____________________________________________
  49.  
  50.      Distribution Code: 6999
  51.      ======================================================================
  52.  
  53.      What kind of computer do you have? ___________________________________
  54.  
  55.      Where did you get your copy of WordJournal? __________________________
  56.  
  57.      ______________________________________________________________________
  58.  
  59.      Are there features you would like to see added to WordJournal? _______
  60.  
  61.      ______________________________________________________________________
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  78.  
  79.                                  FOLD THIS FLAP BACK
  80. ______________________________________________________________________________
  81.  
  82. ________________________                                                 place
  83.                                                                          stamp
  84. ________________________                                                 here
  85.  
  86. ________________________
  87.  
  88.  
  89.  
  90.  
  91.                                    The Software Cobbler
  92.                                    P.O. Box 5743
  93.                                    Auburn, CA 95604
  94.  
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  103. ______________________________________________________________________________
  104.                                  FOLD THIS FLAP BACK
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