home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
The Original Shareware 1.1
/
The Original Shareware (WeMake CDs)(Volume 1.1)(CDs, Inc)(1993).iso
/
25
/
pak151.exe
/
pak
/
ORDER.FRM
< prev
next >
Wrap
Text File
|
1989-01-12
|
2KB
|
65 lines
PAK version 1.5 Registration Form
-----------------------------------------------------------------
Make checks payable to:
NoGate Consulting
P.O. Box 88115
Grand Rapids, MI 49518-0115
-----------------------------------------------------------------
Qty
___ Command line version of PAK @ $15 each $______
___ Full screen version of PAK (PAKF) @ $30 each $______
___ Programmer's version of PAK @ $50 each $______
Subtotal $______
Michigan residents please add 4% sales tax. $______
Shipping and handling - inside the United States $3.50
- or -
- overseas $5.00
Credit Card orders add 3% surcharge $______
Total $______
Diskette type (check or circle one): [ ] 5.25" [ ] 3.5"
Payment: (check or circle one):
[ ] Check [ ] Money Order [ ] Visa [ ] MasterCard
Credit Card #__________________________________________________
Expiration Date _______ Signature ____________________________
Credit Card Orders may be made by phone - (616)455-6270
Checks and Money Orders must be drawn on U.S. banks in U.S. funds
-----------------------------------------------------------------
Name_______________________________________________________
Company_______________________________________________________
Address_______________________________________________________
_______________________________________________________
Phone_________________________ Bus.________________________
Where did you obtain PAK?
_______________________________________________________
Comments_______________________________________________________
_______________________________________________________
_______________________________________________________
-----------------------------------------------------------------