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Text File  |  1997-03-15  |  2KB  |  53 lines
  1. Lastname, Name __________________________________________________________________
  2.  
  3. Company  ________________________________________________________________________
  4.  
  5. Address  ________________________________________________________________________
  6.  
  7.            ______________________________________________________________________
  8.  
  9. Phone    ___________________Fax.:   ___________________ E-Mail  _________________
  10.  
  11.  
  12.  
  13. JDS-Software                        Tel:    +49 4451 959194
  14. Jens Driese                        Fax.:    +49 4451 959196
  15. P.O. Box 1269                        CIS:    100273,2252
  16.                                 
  17. D-26302 Varel                            
  18.                             http://www.jds-software.com
  19.  
  20.  
  21.  
  22. Order:
  23.  
  24. Qty    Product                        Cost per uniti    Total
  25. ________________________________________________________________________________
  26.  
  27. _____    SpeedCommander V    (45US$)                 79,00 DM  = _____ DM
  28.  
  29. _____   Shipping & Handling (10US$)                         15,00 DM  = 15,-  DM    
  30.  
  31. _____    SpeedCommander V    (45US$)  Keycode only, no S&H   79,00 DM  = _____ DM
  32.  
  33. Total                                      = _____ DM
  34.  
  35.  
  36. The total ammount is going to be charged in German Marks (DM)
  37.  
  38.  
  39. Billing method
  40.  
  41.  (  ) Cash
  42.  (  ) Creditcard (VISA/DINERS/EURO/MASTER-CARD)
  43.  
  44.   Cardnumber :_________________________________ Exp.-Date:_____________________
  45.  
  46.   Owner         :________________________________________________________________
  47.  
  48.   Card       : (  )  VISA  (  )  DINERS  (  )  EURO  (  ) MASTER-CARD
  49.  
  50.  
  51.                              _____________________________
  52.                                                              Signature
  53.