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Text File  |  1997-03-20  |  3KB  |  55 lines
  1.  
  2.     ========================================================================
  3.     *** Evaluation Copy ***         ORDER FORM         Sat  10/05/96  Pg   1
  4.     ========================================================================
  5.  
  6.     ORDERED BY:
  7.     
  8.         Name:__________________________________________________________
  9.         Company:_______________________________________________________
  10.         Address:_______________________________________________________
  11.         City:__________________________________________________________
  12.         State:___________  Country__________  Postal Code:_____________
  13.         Phone:_________________________  FAX:__________________________
  14.         E-Mail Address: _______________________________________________
  15.     
  16.         Name of Primary User of this Product  (for technical support
  17.           and security purposes):   ___________________________________
  18.     
  19.     PRODUCTS ORDERED:
  20.     
  21.         1) Business Clock Link v2.6 Site License,
  22.            Printed Manager's Guide (manual),
  23.            Technical Support.                        
  24.            Disk size needed: ___ 3.5"   ___ 5.25"   $149.00  __________
  25.     
  26.         2) Shipping: $4 USA & Canada, $8 International       __________
  27.     
  28.         Total Amount (U.S. Dollars)                          $
  29.                                                              ==========
  30.     
  31.     IF PAYING BY CHECK, OR IF YOU HAVE QUESTIONS, SEND TO:
  32.     
  33.         BizMark Development         Phone: (318) 949-4399
  34.         P.O. Box 182                FAX:   (318) 949-4400
  35.         Princeton, LA 71067-0182    EMail: mhicks@bizmark.com
  36.     
  37.     IF PAYING BY CREDIT CARD, COMPLETE AND CONTACT:
  38.     
  39.         Phone:      800-242-4775    CompuServe: 71355,470
  40.         Phone:      713-524-6394    Internet: 71355.470@compuserve.com
  41.         FAX:        713-524-6398
  42.     
  43.         NOTE! Request Product #11665.
  44.         NOTE! Please include the address of the cardholder.
  45.         NOTE! Orders only at this number. Call BizMark for support.
  46.     
  47.         Card Number: __________________________________________________
  48.                      [ ] VISA   [ ] MC   [ ] Am Express   [ ] Discover
  49.     
  50.         Expiration Date: ________ Signature: __________________________
  51.     
  52.         Name of Cardholder: ___________________________________________
  53.         Address of Cardholder: ________________________________________
  54.                                ________________________________________
  55.