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/ Monster Media 1996 #15 / Monster Media Number 15 (Monster Media)(July 1996).ISO / win_utl2 / wisdom32.zip / SSWISDOM.SC_ / SSWISDOM.SC / UTEXT / ORDER < prev   
Text File  |  1996-06-05  |  2KB  |  65 lines
  1.                                   ORDER FORM
  2.                                   ==========
  3.  
  4.  
  5. Name_______________________________________________________________________
  6.  
  7. Position___________________________________________________________________
  8.  
  9. Organisation________________________________Department_____________________
  10.  
  11. Postal Address______________________________________________P'code_________
  12.  
  13. Phone_________________________________Fax__________________________________
  14.  
  15.  
  16.  
  17.      ( )Yes! Enrol me as a free Screen YY Club Member.
  18.  
  19.  
  20.  
  21.   ____ Single Copies of 'Words of Wisdom'       @ 19.50  $_____________
  22.  
  23.   ____ Yearly Subscription to 'Words of Wisdom' @ 75.00  $_____________
  24.  
  25.  
  26.                                                   TOTAL  $_____________
  27.  
  28. Method of Payment:-
  29. ===================
  30.  
  31. ( )-Bankcard   ( )-Mastercard   ( )-Visa   ( )-Enclosed Cheque
  32.  
  33. Account no: ____  ____  ____  ____  Expiry date___________________________
  34.  
  35. Card holders name (in block letters please) and signature
  36.  
  37. ______________________________ Signature__________________________________
  38.  
  39.  
  40. YOUR QUOTE:-
  41. ============
  42.  
  43. I'd like you to include the following quotation (Optional)
  44.  
  45. __________________________________________________________________________
  46.  
  47. __________________________________________________________________________
  48.  
  49. __________________________________________________________________________
  50.  
  51.  
  52. ( ) Give me an on-screen credit     ( ) I wish to remain anonymous
  53.  
  54.  
  55. Please Note:
  56. ============
  57.  
  58.       * Only quotations considered appropriate for YY Words
  59.         will be included in the YY Words screen saver. Non-
  60.         appropriate quotations will be considered for inclusion in
  61.         other appropriate titles.
  62.  
  63.       * Screen YY reserves the right to change price and availability
  64.         of any product without notice. Prices current as of 01/02/94.
  65.