home *** CD-ROM | disk | FTP | other *** search
/ OS/2 Shareware BBS: 2 BBS / 02-BBS.zip / vdocs.zip / REG.FRM < prev    next >
Text File  |  1993-12-23  |  3KB  |  58 lines
  1.       Order                 VIRTUAL TECHNOLOGIES             Fax:
  2.       Form                      P.O. BOX 1423            210-787-2443
  3.                               ALAMO - TX  78516          210-787-8974
  4.                                                       
  5.  
  6.       Name    ____________________________ Purchase Order ___________
  7.  
  8.       Company ____________________________ Voice Phone  (___)___-____
  9.  
  10.       Title   ____________________________ Data Phone   (___)___-____
  11.  
  12.       Address ____________________________ Fax Number   (___)___-____
  13.  
  14.       City    ____________________________ State/Province ___________
  15.  
  16.       Country ____________________________ Zip/Postal Code___________
  17.  
  18.       Shipping Address(if different) ________________________________
  19.  
  20.       _______________________________________________________________
  21.  
  22.       E-Mail Address _____________________ BBS Name _________________
  23.  
  24.       SOFTWARE ORDER*
  25.                                  QB4.5 DOS               PDS7.1 Beta
  26.                         Quantity Version        Quantity OS/2 Version
  27.                           ----   ---------       ----    ------------
  28.       VBBS 4-Channel      ____   $ 99.00         ____    $ 99.00
  29.       VBBS 8-Channel      ____   $129.00         ____    $129.00
  30.       VBBS 16-Channel     ____   $199.00         ____    $199.00
  31.       VBBS 32-Channel     ____   $275.00         ____    $275.00
  32.       VBBS 64-Channel     ____   $399.00         ____    $399.00
  33.       Virtual ToolKit     ____   $ 49.00
  34.  
  35.       Texas Residents:                           Subtotal   $________
  36.       - add 7.25% State Sales Tax
  37.                                                  Sales Tax  $________
  38.       North America Shipping:
  39.       Free First Class Mail                      Shipping   $________
  40.       UPS- add $5.50   Priority Mail- $2.90       
  41.       Overseas Shipping- add 6%                  TOTAL      $________
  42.  
  43.       Please check your METHOD OF PAYMENT:
  44.  
  45.       Money Order____  Check**____  MasterCard____ VISA____ P.O.____
  46.  
  47.       Please include complete charge card NUMBER and EXPIRATION DATE.
  48.  
  49.       __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Exp.Date _______
  50.  
  51.  
  52.       Signature___________________________________ Date:_____________
  53.  
  54.       *  Please call for upgrade pricing and special versions not listed.
  55.          All prices subject to change without notice.
  56.       ** Please make checks payable to Virtual Technologies and allow up 
  57.          to two weeks for bank clearing.
  58.