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Text File  |  1999-02-01  |  2KB  |  48 lines
  1. -----Order Form-----
  2. (Please print this form, fill it out, and mail it with your payment to complete your order.)
  3.  
  4. **Make Checks or Money Orders Payable to:  Joe Tompkins
  5.  
  6. Send this completed form with payment to:
  7. Joe Tompkins
  8. 130 Wintergreen Ct
  9. Covington, GA 30016
  10.  
  11.  
  12. Your Name___________________________________________
  13.  
  14. -or-
  15.  
  16. School Name__________________________________________
  17.  
  18.  
  19. Email Address (to receive registration code via Email-- Allow 2 weeks for reply):
  20.  
  21. _____________________________________ 
  22.  
  23.  
  24. Mailing Address (to receive registration code via postal mail-- allow 5 weeks for reply)
  25. -United States Addresses ONLY-- All others will receive code via email-
  26.  
  27. Street:______________________________________________________________
  28.  
  29. City________________________________State_________ Zip_________________________
  30.  
  31.  
  32. Please indicate the product(s) you wish to register below:
  33.  
  34. ________________________________________________________________________________________________
  35. Product:            |      Quantity        |    Unit Price    |     Total    |
  36. ------------------------------------------------------------------------------------------------
  37. Vocab-Flash (Single User)    |            |    $10.00 (US)    |        |
  38. ------------------------------------------------------------------------------------------------
  39. Vocab-Flash (Site License)    |            |    $50.00 (US)    |        |
  40. ------------------------------------------------------------------------------------------------
  41. StoryMaker (Single User)    |            |    $10.00 (US)    |        |
  42. ------------------------------------------------------------------------------------------------
  43. StoryMaker (Site License)    |            |    $50.00 (US)    |        |
  44. ------------------------------------------------------------------------------------------------
  45.  
  46.                                     Total Enclosed:
  47.  
  48.