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\pard\plain\pard\ql{\plain\f21\fs24\cf1 \par }
\pard\ql{\plain\f21\fs24\cf1 ****Credit Card Hotline +44 (0)1225 337992****}
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\pard\ql{\plain\f21\fs24\cf1 \par }
\pard\ql{\plain\f21\fs24\cf1 Please Send this Order Form to\:}
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\pard\ql{\plain\f21\fs24\cf1 frEQuency CD-ROM}
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\pard\ql{\plain\f21\fs24\cf1 Modified }
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\pard\ql{\plain\f21\fs24\cf1 Queen Anne House}
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\pard\ql{\plain\f21\fs24\cf1 11 Clarlotte Street }
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\pard\ql{\plain\f21\fs24\cf1 Bath BA1 2NE}
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\pard\ql{\plain\f21\fs24\cf1 UK}
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\pard\ql{\plain\f21\fs24\cf1 \par }
\pard\ql{\plain\f21\fs24\cf1 or Fax it to Modified }
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\pard\ql{\plain\f21\fs24\cf1 +44 (0)1225 311362}
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\pard\ql{\plain\f21\fs24\cf1 \par }
\pard\ql{\plain\f21\fs24\cf1 or call our credit card hotline on +44 (0)1225 337992}
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\pard\ql{\plain\f21\fs24\cf1 ORDER FORM}
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\pard\ql{\plain\f21\fs24\cf1 Please send me __ frEQuency CD-ROM/s for the special introductory price of \'a314.99/$24.99.}
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\pard\ql{\plain\f21\fs24\cf1 This includes post and packaging. }
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\pard\ql{\plain\f21\fs24\cf1 \par }
\pard\ql{\plain\f21\fs24\cf1 \par }
\pard\ql{\plain\f21\fs24\cf1 Name\:}
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\pard\ql{\plain\f21\fs24\cf1 Address\:}
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\pard\ql{\plain\f21\fs24\cf1 Post code/zip\:                      Telephone\:}
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\pard\ql{\plain\f21\fs24\cf1 \par }
\pard\ql{\plain\f21\fs24\cf1 E-mail\:}
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\pard\ql{\plain\f21\fs24\cf1 \par }
\pard\ql{\plain\f21\fs24\cf1 \par }
\pard\ql{\plain\f21\fs24\cf1 method of payment (please tick one only)\:}
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\pard\ql{\plain\f21\fs24\cf1 _ I enclose a cheque made payable to Modified Ltd.}
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\pard\ql{\plain\f21\fs24\cf1 \par }
\pard\ql{\plain\f21\fs24\cf1 Please charge my credit card}
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\pard\ql{\plain\f21\fs24\cf1 _ Visa}
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\pard\ql{\plain\f21\fs24\cf1 _ MasterCard}
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\pard\ql{\plain\f21\fs24\cf1 _ Delta}
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\pard\ql{\plain\f21\fs24\cf1 Name on card}
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\pard\ql{\plain\f21\fs24\cf1 Address on card (if different from above)}
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\pard\ql{\plain\f21\fs24\cf1 Card number\: }
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\pard\ql{\plain\f21\fs24\cf1 \par }
\pard\ql{\plain\f21\fs24\cf1 Expiry date\:}
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\pard\ql{\plain\f21\fs24\cf1 _ Please indicate here if you do not wish to receive details of modified's new products and special offers from now on.}
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\pard\ql{\plain\f21\fs24\cf1 \par }
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\pard\ql{\plain\f21\fs24\cf1 How did you come to hear about us?}
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\pard\ql{\plain\f21\fs24\cf1 Signature\:}
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\pard\ql{\plain\f21\fs24\cf1 \par }
\pard\ql{\plain\f21\fs24\cf1 Date\:}
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\pard\ql{\plain\f21\fs24\cf1 \par }
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\pard\ql{\plain\f21\fs24\cf1 Prices include postage and packaging. Pricing and availability are subject to change without notice. For further information, refer to the terms and conditions of Modified Ltd.}
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\pard\ql{\plain\f21\fs24\cf1 If you have any problems ordering our products, please e-mail\: modified@cix.compulink.co.uk}
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