home *** CD-ROM | disk | FTP | other *** search
/ Best of www.BestZips.com (Collector's Edition) / Best of WWW.BESTZIPS.COM Collector's Edition (JCSM Shareware) (JCS Marketing).ISO / grapprog / splt252.zip / ORDER.FRM < prev    next >
Text File  |  1996-09-15  |  2KB  |  68 lines
  1.       Order Form for SPLOT - The Pen Plotter Simulator (MS-DOS version)
  2.  
  3.  Your Name: _____________________________________________________________
  4.  
  5.  Company: _______________________________________________________________
  6.  
  7.  Address: _______________________________________________________________
  8.  
  9.     City: _____________________________ Prov/State: _____________________
  10.  
  11.  Country: _____________________________ ZIP/Postal: _____________________
  12.  
  13.  E-mail: ______________________________ Tel./Fax:________________________
  14.  
  15.  If you are registered user already, your serial number: ________________
  16.  
  17.   Licence:     [ ]  single user         [ ]  multisystem site
  18.  
  19.   Payment:     [ ]  Cash (money enclosed)
  20.                [ ]  Credit card (fill out credit card information below)
  21.                [ ]  Bank or travelers cheque (payable in US funds)
  22.                [ ]  Send me an invoice first
  23.  
  24.   I'd like to order the SPLOT program for the following plotter type(s):
  25.  
  26.   [ ] HP 7470A ............................................ ___________ US$
  27.  
  28.   [ ] HP 7475A ........................................... ____________ US$
  29.  
  30.   [ ] HP 7440A ColorPro .................................. ____________ US$
  31.  
  32.   [ ] HP 7550A ........................................... ____________ US$
  33.  
  34.   [ ] HP DraftPro ........................................ ____________ US$
  35.  
  36.   [ ] HP DraftMaster ..................................... ____________ US$
  37.  
  38.   [ ] Roland GRX 300/400 ................................. ____________ US$
  39.  
  40.   [ ] Roland DXY ......................................... ____________ US$
  41.  
  42.   Shipping (Outside Europe) .............................. ____________ US$
  43.  
  44.   TOTAL AMOUNT ( US dollars ) ............................ ____________ US$
  45.  
  46.   I hereby authorize the above amount to be charged to my
  47.  
  48.      [ ] MasterCard          [ ] VISA          [ ] American Express
  49.  
  50.   Name as it appears on card:__________________________________________
  51.  
  52.   Credit card number:_______________________ Expiration date:__________
  53.  
  54.   Signature:_________________________________
  55.  
  56.   Your comments: ________________________________________________________
  57.  
  58.   _______________________________________________________________________
  59.  
  60.   _______________________________________________________________________
  61.         (add any additional comments you wish separately)
  62.  
  63.     Mail this form to:      Alexandr Novy
  64.                 Havlickova 2209
  65.                 390 01 TABOR
  66.                 Czech Republic
  67.  
  68.