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Text File  |  1991-10-05  |  1.5 KB  |  35 lines
  1.           OUTRIDER SYSTEMS, INC.
  2.           3701 KIRBY DRIVE SUITE 1196
  3.           HOUSTON TX 77098
  4.           VOICE: (713)521-0486
  5.           FAX:   (713)523-0386
  6.           ORDERS:(800)845-0386
  7.  
  8.           ORDER FORM
  9.  
  10.           DATE:___/___/_______
  11.           NAME:___________________________________________________
  12.           COMPANY:________________________________________________
  13.           ADDRESS:________________________________________________
  14.           CITY:______________________STATE:___  ZIPCODE:__________
  15.           VOICE:(____)____-________         FAX:(____)____-_______
  16.           WHERE DID YOU HEAR ABOUT THIS PRODUCT?__________________
  17.           ________________________________________________________
  18.           ________________________________________________________
  19.  
  20.           SHIP TO:________________________________________________
  21.           ADDRESS:________________________________________________
  22.           CITY:______________________STATE:___  ZIPCODE:__________
  23.  
  24.           CARD: MC/VISA/DISC/AMEX: NO:____________________________
  25.           EXPIRES:___/___
  26.  
  27.           COMMENTS:_______________________________________________
  28.           ________________________________________________________
  29.           ________________________________________________________
  30.           ________________________________________________________
  31.           ________________________________________________________
  32.           ________________________________________________________
  33.           ________________________________________________________
  34.  
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