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pdorform.txt
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Text File
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1992-03-01
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3KB
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68 lines
ATARI COMPUTER ENTHUSIASTS (NSW)
G.P.O. BOX 4515, SYDNEY, 2001, FAX PHONE: 02 6658416
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ORDER FORM FOR PD SOFTWARE FROM THE ACE PD LIBRARY
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PLEASE PRINT:-
NAME:___________________________________________________________
STREET:___________________________________________________________
TOWN:______________________ STATE:______ POST CODE:______
HOME PHONE: (_____)________________
TICK BOXES:
[ ] MONEY ORDER [ ] CHEQUE [ ] CASH
[ ] VISA [ ] MASTERCARD [ ] BANKCARD
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CREDIT CREDIT CARD
CARD NUMBER: ________-________-________-________ EXPIRY DATE : ___/___
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SIGNED:______________________ DATE:___/___/___ MEMBERSHIP #: ____________
FOR: [ ] PREPARED ST SOFTWARE OR [ ] CUSTOM ST SOFTWARE
[ ] SINGLE SIDED 360K DRIVE OR [ ] DOUBLE SIDED 720K DRIVE
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NON-MEMBERS PRICES
$10.00 PER DISK INCLUDES POSTAGE
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ACE(NSW) MEMBERS DISK PRICES
1 - 9 DISKS = $ 7.00 PER DISK INCLUDES POSTAGE
10 + DISKS = $ 6.00 PER DISK INCLUDES POSTAGE
CUSTOM DISK = $10.00 PER DISK INCLUDES POSTAGE
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PRE-PREPARED CUSTOM DISK INFO
ITEM DISK NO. COST ITEM DISK NO COST SIDE PROGRAM NAME
1 _________ ____ 1 _________ ____ ____ ______________
2 _________ ____ 2 _________ ____ ____ ______________
3 _________ ____ 3 _________ ____ ____ ______________
4 _________ ____ 4 _________ ____ ____ ______________
5 _________ ____ 5 _________ ____ ____ ______________
6 _________ ____ 6 _________ ____ ____ ______________
7 _________ ____ 7 _________ ____ ____ ______________
8 _________ ____ 8 _________ ____ ____ ______________
9 _________ ____ 9 _________ ____ ____ ______________
10_________ ____ 10 _________ ____ ____ ______________
TOTAL VALUE: $ ____ TOTAL MONEY SENT = $_______
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OFFICE USE
DATE RECEIVED .../.../... DATE SENT .../.../... CERT MAIL REF #______
RECEIPT # .............. OFFICERS SIGNATURE ..........................
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