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Text File  |  1992-05-29  |  1KB  |  38 lines
  1. -----------------------------------------------------------------
  2.                       KwikDraw Order Form
  3.  
  4.                       The Human Interface
  5.                       902 94th St. S.E.
  6.                       Everett, WA  98208
  7.  
  8.                       (206) 348-9043
  9. -----------------------------------------------------------------
  10.  
  11.  
  12. Name:    ________________________________________________________
  13.  
  14. Address: ________________________________________________________
  15.  
  16. City:    _______________________ State: _______ Zip: ____________
  17.  
  18.  
  19.  
  20. Qty: _______ x $31.95  = $______________      Shipping Rates:
  21.                                               
  22. Shipping (see rates)   = $______________      Qty 1-3:   $3.00
  23.                                               Qty 4-6:   $5.00
  24. Total                  = $______________      Qty 7-10:  $7.00
  25.  
  26.  
  27. please check one:
  28.  
  29. ________  Please ship C.O.D. (U.S. only, $3.00 additional charge)
  30.  
  31. ________  Check enclosed
  32.  
  33. ________  Mastercard No. ________________________________________
  34.  
  35. ________  Visa No. ______________________________________________
  36.  
  37.  
  38. please allow 3 weeks for delivery