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5 Star Games: Windows Edition
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5StarsGames-Windows31Edition.iso
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dcom
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order.frm
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Text File
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1990-02-24
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6KB
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80 lines
dCOM Order Form
┌──────────────────────────────────────────────────────────────────────┐
│ Make checks payable to: Page 1 of 2 │
│ │
│ DAC Micro Systems │
│ 40941 176th St E │
│ Lancaster, CA 93535 │
│ Voice: 805/264-1700 │
│ Data: 805/264-1219 │
│ │
│ 1 copy ___ x $59.00 each $_____ │
│ 2 to 4 copies (10% off) ___ x $53.00 each $_____ │
│ 5 to 9 copies (20% off) ___ x $47.00 each $_____ │
│ 10 to 49 copies (30% off) ___ x $41.00 each $_____ │
│ 50 to 99 copies (40% off) ___ x $35.00 each $_____ │
│ 100+ copies (45% off) ___ x $32.00 each $_____ │
│ │
│ Subtotal $_____ │
│ │
│ California residents please add 6.5% sales tax. $_____ │
│ │
│ Shipping and handling - inside the United States $3.50 │
│ - or - │
│ - overseas $5.00 │
│ │
│ Credit Card orders add 3% surcharge $_____ │
│ │
│ Total $_____ │
│ │
│ Diskette type (check or circle one): [ ] 5.25" [ ] 3.5" │
│ │
│ Processor type (check or circle one): [ ] IBM [ ] Z100 │
│ │
│ Checks & Money Orders must be drawn on US banks in US funds │
│ │
│ Payment (check or circle one): │
│ │
│ [ ] Check [ ] Money Order [ ] Visa [ ] MasterCard │
│ │
│ Credit Card #___________________________________________ │
│ │
│ Expiration Date _______ Signature _____________________ │
│ │
│ Credit Card Orders may be placed by phone: 805/264-1700 │
│ │
└──────────────────────────────────────────────────────────────────────┘
dCOM Version ____ Registration Form
┌──────────────────────────────────────────────────────────────────────┐
│ Page 2 of 2 │
│ │
│ Name_______________________________________________________ │
│ │
│ Company_______________________________________________________ │
│ │
│ Address_______________________________________________________ │
│ │
│ _______________________________________________________ │
│ │
│ Phone_________________________ Bus.________________________ │
│ │
│ Where did you obtain dCOM? │
│ │
│ _______________________________________________________ │
│ │
│ Comments_______________________________________________________ │
│ │
│ _______________________________________________________ │
│ │
│ _______________________________________________________ │
│ │
│ _______________________________________________________ │
│ │
│ _______________________________________________________ │
│ │
│ _______________________________________________________ │
│ │
│ │
└──────────────────────────────────────────────────────────────────────┘