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Text File  |  1993-04-03  |  2KB  |  54 lines
  1.           
  2.           Juneau Gold Nugget & Diamond  Order Form
  3.           118 Seward St.
  4.           Juneau, Ak. 99801
  5.  
  6.  
  7.  Make checks payable to Juneau Gold Nugget & Diamond
  8.  
  9. Name:____________________________________________
  10.                                                       
  11. Adrs:____________________________________________     
  12.     
  13.      ____________________________________________
  14.  
  15. Phone: Hm._______________________ Wk:_______________________
  16.  
  17. QTY    SIZE    COLOR   Cat.#        Description         Each   Total
  18. ____│________│_______│________│_______________________│______│______
  19. ____│________│_______│________│_______________________│______│______
  20. ____│________│_______│________│_______________________│______│______
  21. ____│________│_______│________│_______________________│______│______
  22. ____│________│_______│________│_______________________│______│______
  23.                                            Total Price  ____________
  24.                                            S & H        ____________
  25.                                            Total Cost   ____________
  26.  
  27.  Payment by check ( ) #_______
  28.  Charge ( ) M/C  ( ) VISA   Acct #________________________________
  29.                            Exp.Date______________________________
  30.  Signature:_____________________________
  31.  
  32.                 We suggest you print out the screen of the item(s)
  33.                 you are interested in and tell us size and price 
  34.                 range you want.  Due to the nature of each piece
  35.                 being uniquely different, we will match to your
  36.                 request as close as we can. You will find print 
  37.                 under menu. to print the screen showing on your 
  38.                 screen. 
  39.  
  40. From EPAC's Vacation Alaska 2nd Quarter Issue, VOL I No.1, 1993
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