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Text File  |  1991-04-05  |  2KB  |  57 lines
  1.  
  2.                H Y P E R P A D   O R D E R   F O R M
  3.  
  4. RETURN TO:
  5. Brightbill-Roberts & Co.
  6. 421 University Building
  7. Syracuse, NY 13202
  8.  
  9. TO ORDER:   Return this order form with your payment, or
  10.             if ordering by credit card you can register by
  11.             phone at (315) 474-3400, by Compuserve Mail at
  12.             75300,363 or through our BBS at (315) 472-1058.
  13.  
  14.  
  15. Name:_______________________________ Phone: __________________________
  16.  
  17.  
  18. Company:______________________________________________________________
  19.  
  20.  
  21. Address: ________________________________________ Suite/Apt.__________
  22.  
  23.  
  24. City: ___________________________, State: _________ ZipCode:__________
  25.  
  26.  
  27. Normal HyperPAD Registration                          $ 99.00 ________
  28.  
  29.  
  30. HyperPAD Developer Registration (includes Browser)    $149.00 ________
  31.  
  32.  
  33.                                                      Subtotal ________
  34.  
  35.  
  36.                                    NY residents add sales tax ________
  37.  
  38.  
  39.                     Shipping and handling charge within USA   $ 5.00
  40.  
  41.  
  42.                                                         TOTAL ________
  43.  
  44. [] Check enclosed.  Make payable to Surf Computer Services, Inc.
  45.    or: Charge my  [] Visa  [] MasterCard [] American Express
  46.  
  47. Card No.: ______________________________________ Exp.: __________
  48.  
  49. Name on credit card if different from above:
  50.  
  51.           _______________________________________________________
  52.  
  53.  
  54.  
  55.                Your signature:___________________________________
  56.  
  57.