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Text File  |  1996-06-18  |  1KB  |  44 lines
  1. Product:  Escape! 2.1                       Purchase Order     
  2.                                              Date:________
  3. ____________________________________________________________________
  4.  
  5. Name:
  6. [1]
  7. [2]
  8. [3]
  9. Phone/FAX:   [4]       [5]
  10.  
  11. Email:   [6]
  12.  
  13. Comments:   [7]  
  14.  
  15. Payment Method..........:   [8]
  16. Purchase Order #.......:   [9][10][11]
  17.  
  18. Price per copy................:   $10.00
  19. Number of copies............:   [12]
  20. Quantity Discount...........:   [13]
  21. Send Latest?...(adds $5):   [14]
  22. Disk Size (800k or HD):   [15]
  23. Sales Tax (CA Only).......:   [16]
  24. Note: Sales Tax is only
  25. collected if you've requested
  26. a disk and you live in
  27. California
  28.  
  29. Total Due.........................:   [17]
  30.  
  31. [18]
  32. ____________________________________________________________________
  33. Please send this form to:
  34.  
  35. John V. Holder                                                           Email addresses (AOL is preferred):
  36. 1734 "S" Street                                                         America Online:  JohnHolder
  37. Eureka, CA  95501                                                   Internet...........:  JohnHolder@aol.com
  38. USA                                                                            CompuServe....:  75040,1126
  39.  
  40. Home Page:   http://www.northcoast.com/~jvholder
  41. (check for the latest new releases and updates!)
  42.  
  43. FAX:  (707) 443-3813
  44.