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Text File  |  1995-03-25  |  3KB  |  78 lines
  1.   ************************************************************************
  2.   *                                                                      *
  3.   *                        Jailbird - Version 2.5                        *
  4.   *                 Copyright (c) 1993,94 by LB Software                 *
  5.   *                                                                      *
  6.   *                       Published exclusively by:                      *
  7.   *                         RMH Computer Services                        *
  8.   *                              PO Box  657                             *
  9.   *                       Beech Grove IN 46107-0657                      *
  10.   *                            (317)  782-9903                           *
  11.   *                                                                      *
  12.   ************************************************************************
  13.  
  14. Send registration form and payment to:
  15.  
  16.         Richard Holler
  17.         RMH Computer Services
  18.         PO Box 657
  19.         Beech Grove IN 46107-0657
  20.         USA
  21.  
  22. --------------------------------------------------------------------------
  23.  
  24.         I have enclosed ..(U.S. Funds)................... $19.00
  25.              Others send International Money Order,
  26.              US Funds, please.
  27.  
  28.         Indiana residents please add 5% State sales tax.. $_____
  29.  
  30.         Overseas residents please add $5.00 S/H ......... $_____
  31.  
  32.                                         Total ........... $_____
  33.  
  34. PLEASE PRINT
  35.  
  36. Name...: __________________________________________________________
  37.  
  38. Address: __________________________________________________________
  39.  
  40.        : __________________________________________________________
  41.  
  42.        : __________________________________________________________
  43.  
  44. Phone (required!)....: ______________________    Sales Code: JB250JCSM
  45.  
  46. I would like to receive:  [___] 3-1/2" disks (720k)
  47.                           [___] 5-1/4" disks (1.2M only!)  
  48.  
  49. Do you have an email account" [Y/N] ___
  50.    If yes, address: __________________________________________________
  51.  
  52. I received this program from: _____________________________________
  53.  
  54. ___________________________________________________________________
  55.  
  56.  
  57. CREDIT CARD ORDERS
  58. ------------------
  59.  
  60. For fast Credit Card (MC/VISA/DISCOVER) ordering, please call us at 
  61. 317-782-9903. Or, you can provide the information (including your 
  62. signature!) in the space below. *ALL* spaced must be completed:
  63.  
  64.    +------------------------------------------------------------------+ 
  65.    |    We can accept MasterCard, Visa, and Discover credit cards.    | 
  66.    |                                                                  | 
  67.    |           MasterCard [_]    Visa [_]     Discover [_]            | 
  68.    |                                                                  | 
  69.    | Credit Card Number:  ________  ________  ________  ________      | 
  70.    |                                                                  | 
  71.    | Name on the Card: _____________________________________________  | 
  72.    |                                                                  | 
  73.    | Expires: _______   Signature (*)________________________________ | 
  74.    +------------------------------------------------------------------+ 
  75.             (*) NOTE: This *REQUIRES* a hand-written signature! 
  76.  
  77.  
  78.