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Text File  |  1994-04-24  |  4KB  |  60 lines
  1. +-----------------------------------------------------------------------+
  2. |                                    ORDER FORM                         |
  3. +-----------------------------------------------------------------------+
  4. |Product Name    : The Norton Guide Viewer for OS/2                     |
  5. |Product Version : 1.0                                                  |
  6. +-----------------------------------------------------------------------+
  7. |Client information                                                     |
  8. +-----------------------------------------------------------------------+
  9. |                                                                       |
  10. |NAME      :............................................................|
  11. |           (this name will be used for registration)                   |
  12. |ADDRESS   :............................................................|
  13. |                                                                       |
  14. |ZIPCODE   :............................................................|
  15. |                                                                       |
  16. |CITY/STATE:............................................................|
  17. |                                                                       |
  18. |COUNTRY   :............................................................|
  19. +-----------------------------------------------------------------------+
  20. |Program information                                                    |
  21. +-----------------------------------------------------------------------+
  22. |                                                                       |
  23. |PRICE     : O f 30,--  Giro: 5720973 Bank: 3675.00.493                 |
  24. |                       t.n.v. S. van Loef, Vleuten o.v.v. NGVIEW       |
  25. |            O $ 25,--  Send a check if you live outside The Netherlands|
  26. |           (check one) (made payeble to S. van Loef)                   |
  27. |                                                                       |
  28. |Prices include shipping and handling                                   |
  29. +-----------------------------------------------------------------------+
  30. |                                                                       |
  31. |DATE      :../.../....  SIGNATURE:                                     |
  32. |          (DD/MMM/YYYY)                                                |
  33. |                                                                       |
  34. |                                                                       |
  35. +-----------------------------------------------------------------------+
  36. |Comments/suggestions                                                   |
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  53. |                                                                       |
  54. |                                                                       |
  55. |                                                                       |
  56. +-----------------------------------------------------------------------+
  57. |Send this order form to:                                               |
  58. |S. van Loef, Prof. Bronkhorstlaan 50, 3451 ET VLEUTEN, THE NETHERLANDS |
  59. +-----------------------------------------------------------------------+
  60.