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  1. ****************************************************************************
  2. *                                                                          *
  3. *  VB SERVANTS 3.0 (FOR MICROSOFT VISUAL BASIC 3.0) U.S. ORDER FORM        *
  4. *                                                                          *
  5. ****************************************************************************
  6.  
  7. ********************** CUSTOMER DETAILS ************************************
  8. NAME:
  9. STREET ADDRESS:
  10. SUBURB:
  11. ZIP:
  12. STATE:
  13. COUNTRY:
  14. PHONE:
  15. FAX:
  16. EMAIL:
  17. COMPUSERVE:
  18.  
  19. ************************ ORDER DETAILS *************************************
  20. SINGLE USER LICENSE (US$20): YES/NO
  21. SITE LICENSE (US$60): YES/NO 
  22. CREDIT CARD TYPE:
  23. CREDIT CARD NUMBER:
  24. CREDIT CARD EXPIRY DATE:
  25. NAME ON CREDIT CARD:
  26. CREDIT CARD BILLING ADDRESS:
  27.  
  28.  
  29. ******* SEND YOUR U.S. ORDER TO PsL (ORDERS ONLY - NOT SUPPORT) ************  
  30. PsL
  31. P.O.BOX 35705
  32. HOUSTON, TX 77235-5705
  33. U.S.A.
  34. Phone: 800-2424-PsL OR 713-524-6394
  35. Fax: 713-524-6398
  36. Compuserve: 71355,470
  37. Email: 71355.470@compuserve.com
  38.  
  39. *** For support, contact Learning Freedom, 10 Birdwood Ave, Springwood 2777
  40. Australia. Phone: +61-47-54-3266; Fax: +61-47-51-5946; 
  41. Email: ianbarns@zeta.org.ua
  42.  
  43.