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Text File  |  1996-03-12  |  2KB  |  58 lines
  1.                      "MAGUUCP v3.00C for OS/2" Order Form
  2.                      ------------------------------------
  3.            Complete the form, and mail it with your remittance to:
  4.  
  5.                                Gilmore Systems
  6.                                7354 Rubio Ave.
  7.                          Van Nuys, CA 91406 - U.S.A.
  8.                                     - OR -
  9.          Fax the form with credit card information to: (818) 782-2093
  10.                                     - OR -
  11.              Place your order with us by phone at: (818) 782-1870
  12.                                     - OR-
  13.     Place your order via credit card ONLINE on our BBS at: (818) 782-6290
  14.  
  15. ------------------------------------------------------------------------------
  16.  
  17. Quantity  Product Description                              Price      Total
  18. --------  -----------------------------------------------  --------   --------
  19.  
  20.   ___     MAGUUCP v3.00C for OS/2                          $ 40.00    ________
  21.  
  22.   ___     Shipping/Handling (U.S.=$3, Canada=$4, Other=$5) ________   ________
  23.  
  24.   ___     Sales Tax (California Destinations Only)         ________   ________
  25.  
  26.                                                            TOTAL:   $ ________
  27.  
  28.  
  29. ========================================================
  30. Ship To:                                               < Be certain to fill
  31.                                                        < in the "Ship To"
  32.                                                        < Information!!
  33.                                                        <
  34.                                                        < PURCHASE ORDERS:
  35.                                                        < U.S.-based companies
  36. ======================================================== w/ Dunn & Bradstreet
  37.                                                          number ONLY!
  38.  
  39.  
  40.                                Telephone Number: ____________________________
  41.  
  42.  
  43.                          ----------------------------
  44.                          For Credit Card Orders Only:
  45.                          ----------------------------
  46.  
  47. Check One:   ____ VISA    ____ MASTERCARD    ____ AMERICAN EXPRESS
  48.  
  49.  
  50. Card Number: ______________________________________ Expiration Date: _________
  51.  
  52.  
  53. Your (CardHolder) Name: ______________________________ Today's Date: _________
  54.  
  55.  
  56. Signature of CardHolder: _____________________________________________________
  57.  
  58.