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ORDERFRM.TXT
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1992-01-14
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ORDER FORM FOR FLASHPOINT ZIP/ZIPX FOR WINDOWS
(Version 3.01.03, Preliminary Release 3 -- January 14, 1992)
_____________________________________________________________________
Mail Credit Card Orders to: Mail Non-Credit Card Orders to:
PsL FlashPoint Development
P. O. Box 35705 Attn: Richard S. Patterson
Houston, Texas 77235-5705 P. O. Box 270492
Houston, Texas 77277
Checks, Money Orders and drafts must be made
payable to "Richard S. Patterson"
____________________________________________________________________
Registration/License Fee (Per User/Copy):
Quantity: _____ users/copies at $49.50 $ _________
Less: Quantity Discount of ______ % ( _________ )
Less: Special Discount of ______ % ( _________ )
Total Registration/License Fees $ _________
Site License Fees (see FEES.WRI/TXT file):
Quantity: ______ users/copies at $ _________
Less: Special Discount of ______ % ( _________ )
Total Site License Fees _________
Media Charges for Additional Disks Ordered:
_____ 5.25" disk at $ 9.00 each $ _________
_____ 3.50" disk at $10.00 each _________
Total Media Charges _________
Special Handling Charges:
International Orders: Shipping &
Handling, _______ disks at $7.00 $ _________
Non-U.S. Bank Draft, Check & Money
Order Fees:
Canada $15.00 _________
International $25.00 _________
Total Special Handling Charges _________
TOTAL PAYMENT DUE (U.S. FUNDS): $ _________
____________________________________________________________________
Credit Card Orders: Credit Card: Mastercard ______ Visa _______
Card Number: _________________________________
Expiration Date: ________________
Card Holder Signature: ________________________
____________________________________________________________________
ORDER FORM FOR FLASHPOINT ZIP/ZIPX FOR WINDOWS PAGE 2
(Version 3.01.00, Preliminary Release -- January, 1992)
____________________________________________________________________
Registered Users' Names (attach additional sheets if necessary):
____________________________________________________________________
Purchaser's Name and Shipping Address (Physical and Mailing):
____________________________________________________________________
Purchaser's Authorized Representative/Contact Person and Title:
____________________________________________________________________
Telephone Number(s) (specify day and evening):
____________________________________________________________________
Current Version of Application Registering:
____________________________________________________________________
Payment Method: Cash [ ] Money Order [ ] Credit Card [ ]
Check [ ] Purchase Order [ ] PO No. ______________
____________________________________________________________________
Where or How did you learn of this product:
____________________________________________________________________
Purchaser acknowledges that purchaser or purchaser's representative
has read the terms and conditions contained in the application's
distribution/evaluation package as well as the applications' "About"
dialog panels, and agrees to be bound thereby and by any other
license agreements contained with any product registered, purchased
or shipped. Furthermore, as indicated in the application's distri-
bution/evaluation package, purchaser understands the software and
documentation are provided "as is" and without warranty of any kind,
either express or implied. Purchaser warrants and represents that
the software and documentation will only be used in accordance with
the aforementioned license agreements.
Printed Name: ________________________________________
Signature: ________________________________________
Date: ______________