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Text File  |  1997-01-01  |  2KB  |  47 lines

  1. Rosenthal UnInstall Order Form
  2.  
  3. To: 
  4.                                 _____________________________________________
  5. Rosenthal Engineering           name and shipping address
  6. P.O.Box 1650
  7. San Luis Obispo, CA USA
  8.                   93406         _____________________________________________
  9.                                 address
  10.  
  11. ** PLEASE TYPE OR PRINT **
  12.                                 _____________________________________________
  13.  
  14.  
  15.  
  16.                                 _____________________________________________
  17.                                 city, state zipcode (country)
  18.  
  19.  
  20. Software license registration. (single system each serial number)_  $ 19.95
  21.  
  22.  
  23. Additional systems same site, $5 per serial number 5 X (    ) =  _______.____
  24.  
  25. Upgrading (serial number _______________________) Subtract $5.00
  26.  
  27.                                                   Subtotal     $________.____
  28.  
  29.  
  30. California residents add 7.25% sales tax on subtotal - - - - -   _______.____
  31.  
  32. Shipping and handling per order add $3.50 for USA, 
  33. Canada and Mexico add $4.75. Others add $5.50  - - - - - - - -      ____.____
  34.  
  35.  
  36. Please pay by check or money order in US funds,   -  Total     $________.____
  37. drawn on US banks, Visa or Master Card.
  38.  
  39.  
  40. _________________________ ________________________ _____________
  41. card holder name          Visa/MC number           Expr. date
  42.  
  43. Diskette size (check one) 3 1/2" (   ),   5 1/4" (   )
  44.  
  45. Please! How did you learn of this product?
  46. 0, (ver 08/22/96)
  47.