Software USA
Shareware Library Order Form

(To print this form, click on the print button in the lower right corner of your screen)
Shipping and Billing information

Please Print

Name:________________________________________________________________

Address:_____________________________________________________________

City/Town:___________________________________________________________

State/Province:__________________ Postal/Zip Code:___________________

Phone:(_____)______-_________ Country:__________ Member #:___________

Payment Methods (Credit Card ONLY)
[ ]MasterCard [ ]Visa [ ]American Express [ ]Discover
Credit Card Number:_______________________________Expiration date:______/______/______

Signature:________________________________

Mail completed form to:
Software USA
Attn:Shareware Archives
9565 Waples Street
San Diego, Ca. 92121

Shareware Titles ordered
Fees: $3.00(US) per program/minimum order of 5 programs
Part Number - Program Name
____________-______________________________________

____________-______________________________________

____________-______________________________________
Subtotal $_____________
Sales Tax $____________ (7.75% - CA residents only)
Shipping $_____________ (Charges $4.95(US)/$7.75 (International)) Total $________________