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Text File  |  1999-02-27  |  1.7 KB  |  78 lines
  1. Software USA 
  2. Shareware Library Order Form
  3.  
  4. (To print this form, click on File then Print)
  5.  
  6. Shipping and Billing information
  7.  
  8.  
  9. Please Print
  10.  
  11.  
  12. Name:________________________________________________________________
  13.  
  14.  
  15. Address:_____________________________________________________________
  16.  
  17.  
  18. City/Town:___________________________________________________________
  19.  
  20.  
  21. State/Province:__________________ Postal/Zip Code:___________________
  22.  
  23.  
  24. Phone:(_____)______-_________ Country:__________ Member #:___________
  25.  
  26.  
  27. Payment Methods (Credit Card ONLY)
  28. [ ]MasterCard [ ]Visa [ ]American Express [ ]Discover
  29. Credit Card Number:_______________________________Expiration date:______/______/______
  30.  
  31.  
  32. Signature:________________________________
  33.  
  34.  
  35. Mail completed form to:
  36. Software USA
  37. Attn:Shareware Archives
  38. 9565 Waples Street
  39. San Diego, Ca. 92121
  40.  
  41.  
  42. Shareware Titles ordered
  43. Fees: $3.00(US) per program/minimum order of 5 programs
  44. Part Number - Program Name
  45. ____________-______________________________________
  46.  
  47.  
  48. ____________-______________________________________
  49.  
  50.  
  51. ____________-______________________________________
  52.  
  53.  
  54. ____________-______________________________________
  55.  
  56.  
  57. ____________-______________________________________
  58.  
  59.  
  60. ____________-______________________________________
  61.  
  62.  
  63. ____________-______________________________________
  64.  
  65.  
  66. ____________-______________________________________
  67.  
  68.  
  69. ____________-______________________________________
  70.  
  71.  
  72. ____________-______________________________________
  73.  
  74. Subtotal $_____________
  75. Sales Tax $____________ (7.75% - CA residents only)
  76. Shipping $_____________ (Charges $4.95(US)/$7.75 (International))
  77. Total $________________
  78.