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Text File  |  1994-09-09  |  4KB  |  61 lines
  1. INNOVATIVE BUSINESS TECHNOLOGIES, INC.    ++++++++++++++++++++++                          
  2. 7137 SHADY NELMS DRIVE, SUITE #204        | RexxVIM Order Form |
  3. COLUMBUS, OH 43017                        ++++++++++++++++++++++                          
  4. VOICE/FAX: (614) 791-9055                                                                    
  5.  
  6.                                           Date:  _______________
  7.                                                                   
  8. Company Name:  _________________________________________________       
  9.                                                                   
  10. Name:          _________________________________________________       
  11.                                                                   
  12. Address:       _________________________________________________       
  13.                                                                   
  14. City:          ________________________   State:    ____________       
  15.                                                                   
  16. Zip Code:      ________________________   Country:  ____________       
  17.                                                                   
  18. Telephone:     ________________________                                
  19.                                                                   
  20. Fax:           ________________________                                
  21.  
  22. ================================================================       
  23. Version of ccMail or Lotus Notes currently in use: ____________       
  24.                                                                   
  25. For electronic distribution, please list your e-mail address -
  26.                                                                   
  27. CompuServe        Internet         Prodigy        America Online       
  28.                                                                   
  29. Address:       _________________________________________________       
  30.  
  31. ================================================================       
  32.                                                                   
  33.   Quantity   Product Description           Cost           Total        
  34.                                                                    
  35.   ________   RexxVIM for OS/2           $295.00      __________        
  36.                                                                  
  37.      Shipping and Handling                                 4.00        
  38.                                                                   
  39.      Ohio Residents add 5.75% Sales Tax              __________        
  40.                                                                   
  41.   TOTAL ORDER                                                          
  42.                                                      ==========        
  43.                                                                   
  44. Please send your completed order form, including a check or            
  45. money order (U.S. Funds only) payable to: Innovative Business          
  46. Technologies, Inc.                                                     
  47.  
  48. ================================================================       
  49. For faster service, fax us your order by including your credit         
  50. card information:                                                      
  51.                                                                   
  52. CREDIT CARD:   VISA      MASTERCARD
  53.                                                                   
  54.                                                                   
  55. CREDIT CARD NUMBER: ____________________________________________       
  56.                                                                   
  57. EXPIRATION DATE:    ____________/_______________/_______________       
  58.                                                                   
  59. SIGNATURE:          ____________________________________________
  60. ================================================================                                                                  
  61.