home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
Libris Britannia 4
/
science library(b).zip
/
science library(b)
/
ELECTRON
/
PCB_DESI
/
3614B.ZIP
/
ORDER.FRM
< prev
next >
Wrap
Text File
|
1992-06-21
|
2KB
|
55 lines
Order Form
Name: ______________________________________________________________
Address1: ______________________________________________________________
Address2: ______________________________________________________________
City: __________________________ State: _______ Zip:_________
Country/(other codes): ________________________________________________
Phone Number: (________) ________-______________(Hm#/Wk#/FAX)
Phone Number: (________) ________-______________(HM#/Wk#/FAX)
Computer name: ___________________ Printer type: ____________________
Processor: 8086 8088 80186 80188 80286 80386 80386SX
-----------------------------------------------------------------------------
PC-TRACE # Copies_____ @ $85 ea Total:___________
Includes Disks, Manual, BBS Pasword
-----------------------------------------------------------------------------
Check# ______________
VISA or MC #___________________________________________
Expiration date: _____________
Douglas E. Ehlers
Ehlers Technical Consultants
4520 S. 58th St.
Lincoln, NE 68516
(402) 435-8440 Voice, evenings
(701) 642-3846 BBS 9600,N,8,1