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Text File  |  1996-06-04  |  2KB  |  49 lines
  1. ------------------------------[ ORDER FORM ]----------------------------------
  2. Able Solutions             Phone: 07-3285 7353 (Intl 61-7-3285 7353)           
  3. PO Box 186 Petrie            Fax: 07-3889 0112 (Intl 61-7-3889 0112)
  4. QLD 4502 Australia        Mobile: 015-520 166  Email able@cynergy.com.au
  5. ------------------------------------------------------------------------------
  6.  
  7. Gamepad Pro! 95 (SNES Edition)
  8. [ ] Gamepad Pro! 95 Value Pack.................................($25) __________ 
  9.     - includes Two player cable,
  10.     - registered software,
  11.     - Unlimited Upgrades via the NET
  12. [ ] Two Player Adapter Cable...................................($15) __________
  13. [ ] Gamepad Pro! 95 Registered Software........................($15) __________
  14. [ ] Multitap 4 Player converter (requires two player adapter)..($30) __________
  15.  
  16. [ ] Other: _________________________________________________________ __________
  17.  
  18. [ ] Other: _________________________________________________________ __________
  19.  
  20. Shipping & Handling (International add $2 extra).................... __$3.00___
  21.  
  22.                                                       Total enclosed __________
  23. Disk size:  [ ] 3.5" 1.44M                                                   
  24.             [ ] 3.5" 720k                                                      
  25.             [ ] 5.25" 1.2M          
  26.             [ ] 5.25" 360k       
  27.  
  28.         Name: _______________________________________________________________
  29.  
  30.      Address: _______________________________________________________________
  31.  
  32.  City, State: ___________________________________________ Post Code:_________
  33.  
  34.      Country: ____________________  Phone: __________________________________
  35.  
  36. Payment by:  [ ] Cheque  [ ] Money order  [ ] MasterCard  [ ] Visa [ ] Amex
  37.              [ ] Bankcard (Australia only) 
  38.  
  39. Card # _______________________ Exp Date: _______ Signature: ________________
  40.  
  41. Where did you get this software? _____________________________________
  42.  
  43. Important!  Credit card orders must include the card's "expiration date"
  44. or "expiry date".  Cheques must be in Australian dollars drawn on an
  45. Australian Bank. If this is a problem, please obtain a "postal money order"
  46. from your local post office.
  47.  
  48.  
  49.