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Text File  |  1992-07-13  |  2KB  |  51 lines

  1.  
  2.                         Aciran for Windows Order Form
  3.  
  4.         NAME:     ______________________________________________________
  5.  
  6.         COMPANY:  ______________________________________________________
  7.  
  8.         ADDRESS:  ______________________________________________________
  9.  
  10.                   ______________________________________________________
  11.  
  12.         CITY:     ______________________________________________________
  13.  
  14.         COUNTY:   ________________________  Post/Zip Code:  ____________
  15.  
  16.         PHONE:    ______________________________________________________
  17.  
  18.         E-MAIL ADDRESS:  _______________________________________________
  19.  
  20.         WHERE DID YOU HEAR OF Aciran?  _________________________________
  21.  
  22.         ________________________________________________________________
  23.  
  24.         COMMENTS:  _____________________________________________________
  25.  
  26.         ________________________________________________________________
  27.  
  28.  
  29.        Registration @ £65.00                                £__________
  30.  
  31.         Floppy Disk Type, Tick one                      5.25"     _____
  32.  
  33.                                                         3.5"      _____
  34.  
  35.         Shipping outside U.K. @ £1.50                         __________
  36.             (Payments MUST be in Pounds Stering)
  37.  
  38.  
  39.                                                  SUBTOTAL:   £__________
  40.  
  41.  
  42.                                                     TOTAL:   £__________
  43.  
  44.         Remit to:         Aciran Software Systems
  45.                           29 Duncryne Place,
  46.                           Bishopbriggs,
  47.                           Glasgow
  48.                           Scotland G64 2DP
  49.                           United Kingdom
  50.  
  51.