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Text File  |  1996-11-20  |  2.7 KB  |  68 lines
  1. ****************************************************************************
  2. **                                                                        **
  3. **           ------------------------------------------------             **
  4. **           SRC Enterprises Slider Custom Control Order Form             **
  5. **           ------------------------------------------------             **
  6. **                                                                        **
  7. **                          Send order to:                                **
  8. **                                                                        **
  9. **                       Steven R Clabaugh                                **
  10. **                       550 N. Pantano Rd. #286                          **
  11. **                       Tucson, Arizona  85710                           **
  12. **                                                                        **
  13. ****************************************************************************
  14.  
  15.  
  16. Name (Please Print) ________________________________________________________
  17.  
  18. Address ____________________________________________________________________
  19.  
  20. City _______________________________________________________________________
  21.  
  22. State ___________________________________ ZIP Code _________________________
  23.  
  24. Phone/Fax __________________________________________________________________
  25.  
  26.  
  27. Payment Method: Check [ ]     Money Order [ ]     Bank Cashiers Check [ ]
  28.  
  29. Payable to: Steven R Clabaugh
  30.  
  31.  
  32.  
  33. Number of Copies _______________________ ( $15.00 per copy ) $  ____________
  34.  
  35.                    Shipping and Handling ( $5.00 per order ) $  ____________
  36.  
  37.                                       Total Amount Enclosed: $  ____________
  38.  
  39.  
  40.  
  41. All orders will be shipped on 3.5" HD diskette to the above address unless
  42. otherwise specified.
  43.  
  44. ____________________________________________________________________________
  45.  
  46. ____________________________________________________________________________
  47.  
  48. ____________________________________________________________________________
  49.  
  50. ____________________________________________________________________________
  51.  
  52. ____________________________________________________________________________
  53.  
  54. ____________________________________________________________________________
  55.  
  56. ____________________________________________________________________________
  57.  
  58.  
  59. And if you have the time, where did you get the shareware version from?
  60.  
  61. ____________________________________________________________________________
  62.  
  63. ____________________________________________________________________________
  64.  
  65.  
  66. Your order is greatly appreciated!!
  67. Steven Clabaugh
  68.