home *** CD-ROM | disk | FTP | other *** search
/ AOL File Library: 4,101 to 4,200 / aol-file-protocol-4400-4101-to-4200.zip / AOLDLs / Business Management / PVTSEC_ V1.13E Private Secretary / PVTS113E.exe / PSBLANK.FRM < prev    next >
Text File  |  1995-09-25  |  2KB  |  57 lines

  1.                  PRIVATE SECRETARY(tm)  REGISTRATION/ORDER FORM
  2.                  ======================+++++===================
  3.      
  4.      NAME:______________________________
  5.      
  6.      COMPANY:___________________________ (IF APPLICABLE)
  7.      
  8.      ADDRESS:___________________________
  9.      
  10.              ___________________________
  11.      
  12.      CITY:_________________STATE/PROV.__________POSTAL CODE_______-______
  13.  
  14.      COUNTRY:______________ PHONE: (    ) _____________________
  15.      ---------------------------------------------------------------------
  16.      
  17.      SERIAL NUMBER: ____________  VERSION: ________________
  18.      
  19.      WHERE AQUIRED:________________________________________
  20.  
  21.      [ ] PLEASE NOTIFY ME OF FUTURE UPDATES WHEN AVAILABLE.
  22.      
  23.      COMMENTS: ______________________________________________________
  24.      
  25.                ______________________________________________________
  26.      _____________________________________________________________________
  27.      
  28.      ORDER AMOUNT:
  29.      
  30.      DOS REGISTRATION FEE (INCLUDING USER MANUAL)   ($25.00 EA.) _________
  31.      
  32.      DOS DISKETTE W/LATEST RELEASE [ ] 3.5  [ ] 5.25 ($5.00 EA.) _________
  33.      
  34.      PRIVATE SECRETARY FOR WINDOWS (W/REGISTRATION) ($34.95 EA.) _________
  35.      (includes 3.5" diskette and on-line help)
  36.  
  37.      WINDOWS UPGRADE FOR REGISTERED DOS USERS       ($15.00 EA.) _________
  38.      
  39.      FOR RESIDENTS OF CALIFORNIA             (SALES AND USE TAX) _________
  40.      
  41.      SHIPPING            (US=$1, CANADA=$1.50, ALL OTHERS=$3.00) _________
  42.  
  43.                                                          TOTAL: $_________
  44.      CREDIT CARD: [ ] VISA [ ] MASTERCARD [ ] AMEX
  45.  
  46.      ACCOUNT#____________________________________________EXP______________
  47.  
  48.      AUTHORIZED SIGNITURE_________________________________________________ 
  49.      =====================================================================
  50.      IF USING CREDIT CARD, YOU MAY ORDER BY PHONE/FAX 1,800-537-0782 OR
  51.      (408)-370-1773.  OTHERWISE, PLEASE SEND CASH, CHECK OR MONEY ORDER
  52.      FOR TOTAL ABOVE. SEND COMPLETED ORDER FORM TO:
  53.   
  54.            INTEGRATED SUPPORT TECHNOLOGY     ****************************
  55.          478 W. HAMILTON AVE. * SUITE 191    * THANKS! FOR YOUR SUPPORT *
  56.                 CAMPBELL, CA 95008           ****************************
  57.