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Text File  |  1996-02-14  |  4KB  |  85 lines
  1.  
  2.   ************************************************************************
  3.   *                                                                      *
  4.   *                       MusicEase - Version 4.23                       *
  5.   *                   Copyright 1990-1995 by Gary Rader                  *
  6.   *                                                                      *
  7.   *                       Published exclusively by:                      *
  8.   *                         RMH Computer Services                        *
  9.   *                              PO Box  657                             *
  10.   *                       Beech Grove IN 46107-0657                      *
  11.   *                            (317)  782-9903                           *
  12.   *                                                                      *
  13.   ************************************************************************
  14.  
  15.                                   ORDER FORM
  16.  
  17. --------------------------------------------------------------------------
  18.  Send registration     RMH Computer Services           [  you can call   ]
  19. form and payment to:   PO BOX 657                      [  317-782-9903   ]
  20.                        BEECH GROVE, IN 46107-0657      [  to order via   ]
  21.                        USA                             [ VISA/MasterCard ]
  22. --------------------------------------------------------------------------
  23.  
  24.  I have enclosed (US Funds)..................................... $_____
  25.    [ ] Standard Version     -  $49.00
  26.    [ ] Professional Version -  $99.00
  27.        (see Appendix for details of Professional Version)
  28.    [ ] Sample Files Only    -  $ 5.00*
  29.        (* Sample files are included with all
  30.         registered versions at no extra charge!)
  31.  
  32.  *** Indiana residents please add 5% State sales tax ........... $_____
  33.  
  34.  Shipping/Handling ............................................. $_____
  35.    [ ] USA residents please add .............. $3.00 S/H
  36.    [ ] Canada/Mexico residents please add .... $5.00 S/H
  37.    [ ] Other residents please add ............ $8.00 S/H
  38.  
  39.                                         Total .................. $_____
  40.  
  41.  
  42. PLEASE TYPE OR PRINT (all information will remain confidential)
  43.  
  44. Name...: __________________________________________________________
  45.  
  46. Address: __________________________________________________________
  47.  
  48.        : __________________________________________________________
  49.  
  50.        : __________________________________________________________
  51.  
  52. Name to be branded into program: __________________________________
  53.                                       (51 characters maximum)
  54.  
  55. Phone Number (Required)..: ___________________    Sales Code: ME423JCSM
  56.  
  57. Do you have an email account? [y/n]: ____  
  58.    If yes, address: ___________________________________________________
  59.  
  60. I would like to receive:  [___] 3-1/2" disks (720k)
  61.                           [___] 5-1/4" disks (360k)  
  62.  
  63.  
  64.  
  65. CREDIT CARD ORDERS
  66. ------------------
  67.  
  68. For fast Credit Card (MC/VISA) ordering, please call us at 317-782-9903. 
  69. Or, you can provide the information (including your signature!) in the 
  70. space below. *ALL* spaced must be completed:
  71.  
  72.    +------------------------------------------------------------------+ 
  73.    | We can accept MasterCard or Visa credit card payments.  Fill out | 
  74.    | the following ONLY if you are making payment by MC or Visa.      | 
  75.    |                                                                  | 
  76.    | MasterCard [_]    Visa [_]     Number [____  ____  ____  ____]   | 
  77.    |                                                                  | 
  78.    | Name on the Card [_____________________________________________] | 
  79.    |                                                                  | 
  80.    | Expires [_______]  Signature (*)________________________________ | 
  81.    +------------------------------------------------------------------+ 
  82.             (*) NOTE: This *REQUIRES* a hand-written signature! 
  83.  
  84.  
  85.