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Text File  |  1991-12-08  |  3KB  |  70 lines
  1. Order form for Alchemy Mindworks' shareware: [ ] 5 1/4 [ ] 3 1/2 inch disks
  2.  
  3. Name (yours) _________________________________________________________
  4.  
  5. Address (likewise, yours) ____________________________________________
  6.  
  7.               ____________________________________________
  8.  
  9. City/town ____________________________________________________________
  10.  
  11. Province/state _______________________Post/zip code __________________
  12.  
  13. Country ______________________________________________________________
  14.  
  15. Daytime phone number _________________________________________________
  16.  
  17. FAX number ___________________________________________________________
  18.  
  19. Computer used (no idea why we want to know this) _____________________
  20.  
  21. Payment: [ ] Visa (see below)              [ ] Cheque
  22.      [ ] Cash (take your chances)    [ ] Other (no chickens, please)
  23.  
  24. I'd like to order the following Alchemy Mindworks shareware:
  25.  
  26. [ ] Graphic Workshop                                         $40.00
  27. [ ] GrafCat                                                  $40.00
  28. [ ] Desktop Paint (monochrome)                               $40.00
  29. [ ] Desktop Paint 256                                        $40.00
  30. [ ] Image Gallery                                            $40.00
  31. [ ] Desktop Paint font toolkit disk                          $10.00
  32. [ ] Graphic Workshop update for previously registered copy   $20.00
  33. [ ] GrafCat update for previously registered copy            $20.00
  34. [ ] Desktop Paint update for previously registered copy      $20.00
  35. [ ] Desktop Paint 256 update for previously registered copy  $20.00
  36. [ ] Other
  37. _______________________________________________________________________
  38.  
  39. Canadian residents please add GST (it wasn't our idea)    _____________
  40.  
  41. Ontario residents please add PST (nor this)               _____________
  42.  
  43. TOTAL                                                     _____________
  44.  
  45. If you're ordering from outside Canada, please make your payment in US
  46. dollars. The exchange more or less covers the extra postage.
  47. _______________________________________________________________________
  48.  
  49. Payment by Visa card:
  50.  
  51. We can only accept Visa cards (no American Express or MasterCards, please.)
  52. We will need the following information:
  53.  
  54. Credit card number: ______________________________________________________
  55.  
  56. Expiry date: _____________________________________________________________
  57.  
  58. Bank the card's drawn on: ________________________________________________
  59.  
  60. The name as it appears on the card: ______________________________________
  61.  
  62. The signature of its owner authorizing us
  63. to debit it for the amount indicated above: ______________________________
  64.  
  65. _______________________________________________________________________
  66.  
  67. Mail this form to:    Alchemy Mindworks Inc., P.O. Box 500, Beeton,
  68.               Ontario L0G 1A0, Canada. If you're paying by
  69.               credit card, you can FAX it to (416) 729-4156.
  70.