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Text File  |  1997-12-05  |  1.8 KB  |  75 lines
  1. Software USA 
  2. Shareware Library Order Form
  3. _____________________________________________________________________
  4. Shipping and Billing information (Please Print)
  5.  
  6.  
  7. Name:________________________________________________________________
  8.  
  9.  
  10. Address:_____________________________________________________________
  11.  
  12.  
  13. City/Town:___________________________________________________________
  14.  
  15.  
  16. State/Province:__________________ Postal/Zip Code:___________________
  17.  
  18.  
  19. Phone:(_____)______-_________ Country:__________ Member #:___________
  20.  
  21.  
  22. Payment Methods (Credit Card ONLY)
  23. [ ]MasterCard [ ]Visa [ ]American Express [ ]Discover
  24. Credit Card Number:_______________________________Expiration date:______/______/______
  25.  
  26.  
  27. Signature:________________________________
  28.  
  29.  
  30. Mail completed form to:
  31. Software USA
  32. Attn: Shareware Archives
  33. 9909 Huennekens Street
  34. San Diego, CA 92121-2929
  35.  
  36.  
  37. Shareware Titles ordered
  38. Fees: $3.00(US) per program/minimum order of 5 programs
  39. _____________________________________________________________________
  40. Part Number - Program Name
  41.  
  42. ____________-______________________________________
  43.  
  44.  
  45. ____________-______________________________________
  46.  
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  48. ____________-______________________________________
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  50.  
  51. ____________-______________________________________
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  53.  
  54. ____________-______________________________________
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  57. ____________-______________________________________
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  60. ____________-______________________________________
  61.  
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  63. ____________-______________________________________
  64.  
  65.  
  66. ____________-______________________________________
  67.  
  68.  
  69. ____________-______________________________________
  70.  
  71. Subtotal $_____________
  72. Sales Tax $____________ (7.75% - CA residents only)
  73. Shipping $_____________ (Charges $4.95(US)/$7.75 (International))
  74. Total $________________
  75.