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ORDER.TX_
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ORDER.TX
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Text File
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1995-10-29
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2KB
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44 lines
YOU MAY EDIT THIS FORM AND PRINT, OR PRINT AND COMPLETE IN PEN
----------------------------------------------------------------
Mail-in Registration Form
I would like to purchase the product(s) shown below. Please ship
a licensed version to the following address:
NAME ________________________________________________________
ADDRESS ________________________________________________________
________________________________________________________
CITY_______________________STATE____ZIP________COUNTRY__________
DAYTIME PHONE (___)____-_______ EVENING PHONE (___)____-_______
QUANTITY UNIT PRICE COST
-------- ---------- ------
PlanStar _____ X $49.00 = $______
CallStar _____ X $20.00 = $______
PlanStar Gold (both of the above) _____ X $69.00 = $______
SUBTOTAL $______
VA Residents add 4.5% $______
Shipping (US $0, Canada $2, Elsewhere $5) $______
TOTAL $______
PAYMENT MADE BY:
____CHECK, drawn on an American Bank, made payable to HENNING ASSOCIATES.
MAIL TO: Henning Associates
Rt. 2, Box 526-A
Crozet, VA 22932
____CREDIT CARD
____VISA ____MasterCard
Card number _________________________________________________________
Expiration date ____/____ Signature:_______________________________