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Text File  |  1994-01-26  |  3KB  |  83 lines
  1.   ************************************************************************
  2.   *                                                                      *
  3.   *                  Car Restoration Diary - Version 2.31                *
  4.   *               Copyright (c) 1993  by BlueCollar 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.                                   ORDER FORM
  15.                                   ----------
  16.  
  17. Send registration form and payment to:
  18.  
  19.         Richard Holler
  20.         RMH Computer Services
  21.         PO Box 657
  22.         Beech Grove IN 46107-0657
  23.         USA
  24.  
  25. --------------------------------------------------------------------------
  26.  
  27.         I have enclosed ..(U.S. Dollars)............. ___ $29.00
  28.              Others send International Money Order,
  29.              US Funds, please.
  30.  
  31.         Indiana residents please add 5% State sales tax.. $_____
  32.  
  33.         Overseas residents please add $5.00 S/H .......   $_____
  34.  
  35.                                         Total             $_____
  36.  
  37. PLEASE PRINT
  38.  
  39. Name...: __________________________________________________________
  40.  
  41. Address: __________________________________________________________
  42.  
  43.        : __________________________________________________________
  44.  
  45.        : __________________________________________________________
  46.  
  47. Phone..: ______________________              Sales Code: CRD231JCSM
  48.  
  49. Email Address (if available): _____________________________________
  50.  
  51. I would like to receive:  ____ 5-1/4" disks   ____ 3-1/2" disks.
  52.  
  53.  
  54. I received this program from: _____________________________________
  55.  
  56.                               _____________________________________
  57.  
  58.                               _____________________________________
  59.  
  60.  
  61.  
  62. CREDIT CARD ORDERS
  63. ------------------
  64.  
  65. For fast Credit Card (MC/VISA/DISCOVER) ordering, please call us at 
  66. 317-782-9903. Or, you can provide the information (including your 
  67. signature!) in the space below. *ALL* spaced must be completed:
  68.  
  69.    +------------------------------------------------------------------+ 
  70.    |    We can accept MasterCard, Visa, and Discover credit cards.    | 
  71.    |                                                                  | 
  72.    |           MasterCard [_]    Visa [_]     Discover [_]            | 
  73.    |                                                                  | 
  74.    | Credit Card Number:  ________  ________  ________  ________      | 
  75.    |                                                                  | 
  76.    | Name on the Card: _____________________________________________  | 
  77.    |                                                                  | 
  78.    | Expires: _______   Signature (*)________________________________ | 
  79.    +------------------------------------------------------------------+ 
  80.             (*) NOTE: This *REQUIRES* a hand-written signature! 
  81.  
  82.  
  83.