home *** CD-ROM | disk | FTP | other *** search
/ JCSM Shareware Collection 1993 November / JCSM Shareware Collection - 1993-11.iso / cl580 / mlrcc25.lzh / REGISTER.TXT < prev    next >
Text File  |  1993-08-01  |  3KB  |  56 lines
  1.                                My Little Realm Order Form
  2.  
  3.           Last: ___________________________  First: ________________  M.I. ___
  4.  
  5.           Address: ___________________________________________________________
  6.  
  7.           City: _________________________________________  State: ____________
  8.  
  9.           Zip: ________________ Home Phone: (________) _______________________
  10.  
  11.           Note:  All program disks will be sent to this address.
  12.           ____________________________________________________________________
  13.  
  14.           Indicate which programs you are purchasing:
  15.  
  16.                 ____  Calling Cards              ____  Public Library
  17.                 ____  Charge Card                ____  Read More
  18.                 ____  Checking                   ____  Records of the Realm
  19.                 ____  Private Library            ____  Savings
  20.  
  21.           Number of programs purchased _____ at $20 each          _________
  22.           ____________________________________________________________________
  23.  
  24.           Bonus program:  ____________________________________________________
  25.           Limit:  One bonus program with your order.
  26.           ____________________________________________________________________
  27.  
  28.           ____  I'd rather save $100!  Rush me MLR/the System for only $60.
  29.  
  30.           My Little Realm/The System   _______   at  $60/system   _________
  31.           ____________________________________________________________________
  32.  
  33.                                               Shipping/Handling   __$5.00__
  34.  
  35.                                                        Subtotal   _________
  36.  
  37.                    New Jersey residents please add 6% sales tax   _________
  38.  
  39.                                        Total amount of purchase   _________
  40.           ____________________________________________________________________
  41.           
  42.           Disk size:   _____   5 1/4"   _____   3 1/2"    (Disks are DS/DD)
  43.  
  44.           Vendor/BBS name:  __________________________________________________
  45.           ____________________________________________________________________
  46.  
  47.           Please send your check or money order to:  
  48.  
  49.                               John L. Salisbury 
  50.                               22 Church Street #103, Suite 376
  51.                               Ramsey, New Jersey 07446
  52.  
  53.           Checks and money orders must be drawn on U.S. banks in U.S. funds.
  54.           Sorry, phone orders cannot be accepted.  Prices subject to change.
  55.           ____________________________________________________________________
  56.