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Text File  |  1994-01-11  |  3KB  |  58 lines
  1.                           THE LAWN MOWER SHOP
  2.                            Parts Order Form
  3.                  
  4.  
  5.     Fill out the information below, total your order, mail 
  6.     or fax the form and your certified check, money order, 
  7.     or credit card information (Visa or Master Card only).
  8.  
  9.  
  10. Mail to :  DIY Software Inc.                      Phone (803) 859-1678
  11.        6432 Calhoun Memorial Hiway            Fax  ( 803) 859-0666
  12.        Easley,  SC     29640                  Time Zone - E.S.T.
  13.  
  14.                       
  15. Your Name ____________________________________________________________
  16.  
  17. Company  _____________________________________________________________
  18.  
  19. Address  _____________________________________________________________
  20.  
  21. ______________________________________________________________________
  22.  
  23. Model#  ______________________________________________________________
  24.  
  25. Credit Card Info.
  26.  
  27. __Visa __ MC    Card#____________________________ Exp.Date____________
  28.  
  29. Signature __________________________________Phone# (____)_____________
  30.  
  31.      ***********************************************************
  32.                         Amt     Cost      Total
  33. Description               Part Number       Ord'd   Each      Cost  
  34.          
  35. ______________________________________________________________________
  36. ______________________________________________________________________
  37. ______________________________________________________________________
  38. ______________________________________________________________________
  39. ______________________________________________________________________
  40. ______________________________________________________________________
  41. ______________________________________________________________________
  42. ______________________________________________________________________
  43. ______________________________________________________________________
  44. ______________________________________________________________________
  45. ______________________________________________________________________
  46. ______________________________________________________________________
  47. ______________________________________________________________________
  48. ______________________________________________________________________
  49.  
  50.                                                 Sub Total  $__________
  51.  
  52.                                                  Discount  $ -________
  53.  
  54.               Shipping & Handling, 20% or $ 5.00 minimum   $__________                         ( Overpayment refunded with order )  
  55.                    South Carolina Residents add 5% tax  $__________
  56.  
  57. Indicate Disk Format  3.5"__  5.25"__         Total of Order  $__________
  58.