A T A R I   C O M P U T E R   E N T H U S I A S T S ( N . S . W . )
                      G.P.O. Box 4514, SYDNEY 2001, N.S.W.
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                   S O F T W A R E  O R D E R  F O R M
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      PLEASE PRINT ALL INFORMATION:-

      NAME:___________________________________________________________

    STREET:___________________________________________________________

      TOWN:___________________________________ POST CODE:_____________

      Phone: (    ) ____________________
      Please Tick Boxes:
    [_] MONEY ORDER     [_] CHEQUE       [_] CASH    [_] CREDITS
For:[_] PREPARED   ST  SOFTWARE          [_] CUSTOM  ST   SOFTWARE
    [_] Single Sided ST Disk Drive       [_] Double Sided ST Disk Drive

     SIGNED:_____________________________________  DATE:____/____/____
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                         Prepared ST Disk Prices:
                    1 - 9 Disks  = $ 7.00 Per Disk includes Postage
                   10 +   Disks  = $ 6.00 Per Disk includes Postage
                     CUSTOM DISK = $10.00 Per Disk includes Postage
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  PRE-PREPARED                              CUSTOM DISK INFO
 ITEM DISK NO.      COST         ITEM DISK NO  cost  SIDE   PROGRAM NAME

  1 _________      ____          1 _________   ____  ____   ____________

  2 _________      ____          2 _________   ____  ____   ____________

  3 _________      ____          3 _________   ____  ____   ____________

  4 _________      ____          4 _________   ____  ____   ____________

  5 _________      ____          5 _________   ____  ____   ____________

  6 _________      ____          6 _________   ____  ____   ____________

  7 _________      ____          7 _________   ____  ____   ____________

  8 _________      ____          8 _________   ____  ____   ____________

  9 _________      ____          9 _________   ____  ____   ____________

  10_________      ____         10 _________   ____  ____   ____________

 TOTAL Items:     ____   Disks Value Total $____.___     Postage $___.__

                        TOTAL MONEY SENT = $___.___
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 OFFICE USE
 DATE RECEIVED .../.../...  DATE SENT .../.../...  Cert Mail Ref #______

 RECEIPT # ..............   OFFICERs SIGNATURE ..........................
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