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500 MB Nyheder Direkte fra Internet 6
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500 MB nyheder direkte fra internet CD 6.iso
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assimil8
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order.frm
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Text File
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1995-06-24
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2KB
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48 lines
==============================
ASSIMILATION REGISTRATION FORM
==============================
YES, I'd like to receive registered Assimilation!
Return completed form via mail, or e-mail!
NAME:_____________________________________________________
ADDRESS:_____________________________________________________
_____________________________________________________
CITY:________________________ STATE/PROV:_________________
ZIP CODE:____________________ PHONE/FAX:______________________
COUNTRY:_______________
Canadian orders: $16.00 per copy
U.S. orders: $13.00 per copy
** Shipping & Handling is include in price!
Canadian ORDERS: ----- copies @ $16.00 ea : -------
U.S. ORDERS: _____ copies @ $13.00 ea : _______
>> TOTAL PAYMENT : _______
PAYMENT TYPE: ( ) Check ( ) Money Order
** Do not send cash in the mail!
Make orders payable to Perry Robertson
ALL ORDERS GO TO:
Perry Robertson
156 Chartwell Drive, Apt. 103
Sault Ste. Marie, ON, Canada
P0S 1E0
Or phone: (705) 946-5126 between 9:00am - 5:00pm Monday - Friday
E-mail: perry.robertson@csrnet-bbs.com