home *** CD-ROM | disk | FTP | other *** search
/ Floppyshop 2 / Floppyshop - 2.zip / Floppyshop - 2.iso / diskmags / 0022-3.564 / dmg-3449 / text / pdorform.txt < prev    next >
Text File  |  1992-03-01  |  3KB  |  68 lines

  1.  
  2.                      ATARI COMPUTER ENTHUSIASTS (NSW)
  3.             G.P.O. BOX 4515, SYDNEY, 2001,   FAX PHONE: 02 6658416
  4. ----------------------------------------------------------------------------
  5.             ORDER FORM FOR PD SOFTWARE FROM THE ACE PD LIBRARY                        
  6. ----------------------------------------------------------------------------
  7. PLEASE PRINT:-
  8.  
  9.   NAME:___________________________________________________________
  10.  
  11. STREET:___________________________________________________________
  12.  
  13.   TOWN:______________________  STATE:______  POST CODE:______
  14.  
  15.               HOME PHONE: (_____)________________
  16. TICK BOXES:
  17.              [ ] MONEY ORDER    [ ] CHEQUE         [ ] CASH
  18.              [ ] VISA           [ ] MASTERCARD     [ ] BANKCARD
  19. ----------------------------------------------------------------------------
  20.     CREDIT                                           CREDIT CARD
  21.   CARD NUMBER: ________-________-________-________   EXPIRY DATE : ___/___
  22. ----------------------------------------------------------------------------
  23.  
  24. SIGNED:______________________  DATE:___/___/___   MEMBERSHIP #: ____________
  25.  
  26. FOR:       [ ] PREPARED   ST  SOFTWARE   OR     [ ] CUSTOM  ST   SOFTWARE
  27.            [ ] SINGLE SIDED 360K DRIVE   OR     [ ] DOUBLE SIDED 720K DRIVE
  28. ----------------------------------------------------------------------------
  29.                         NON-MEMBERS PRICES
  30.                  $10.00 PER DISK INCLUDES POSTAGE
  31. ----------------------------------------------------------------------------
  32.                       ACE(NSW) MEMBERS DISK PRICES
  33.              1 - 9 DISKS  = $ 7.00 PER DISK INCLUDES POSTAGE
  34.             10 +   DISKS  = $ 6.00 PER DISK INCLUDES POSTAGE
  35.               CUSTOM DISK = $10.00 PER DISK INCLUDES POSTAGE
  36. ----------------------------------------------------------------------------
  37.   PRE-PREPARED                              CUSTOM DISK INFO
  38.  ITEM DISK NO.     COST         ITEM DISK NO  COST  SIDE   PROGRAM NAME
  39.  
  40.   1 _________      ____          1 _________   ____  ____   ______________
  41.  
  42.   2 _________      ____          2 _________   ____  ____   ______________
  43.  
  44.   3 _________      ____          3 _________   ____  ____   ______________
  45.  
  46.   4 _________      ____          4 _________   ____  ____   ______________
  47.  
  48.   5 _________      ____          5 _________   ____  ____   ______________
  49.  
  50.   6 _________      ____          6 _________   ____  ____   ______________
  51.  
  52.   7 _________      ____          7 _________   ____  ____   ______________
  53.  
  54.   8 _________      ____          8 _________   ____  ____   ______________
  55.  
  56.   9 _________      ____          9 _________   ____  ____   ______________
  57.  
  58.   10_________      ____         10 _________   ____  ____   ______________
  59.  
  60.  TOTAL VALUE:    $ ____        TOTAL MONEY SENT = $_______
  61. ----------------------------------------------------------------------------
  62.  OFFICE USE
  63.  DATE RECEIVED .../.../...  DATE SENT .../.../...  CERT MAIL REF #______
  64.  
  65.   RECEIPT # ..............   OFFICERS SIGNATURE ..........................
  66. ----------------------------------------------------------------------------
  67.  
  68.