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  1. Software USA 
  2. Shareware Library Order Form
  3.  
  4. (To print this form, click on the print button in the lower 
  5. right corner of your screen)
  6. Shipping and Billing information
  7.  
  8. Please Print
  9.  
  10. Name:________________________________________________________________
  11.  
  12. Address:_____________________________________________________________
  13.  
  14. City/Town:___________________________________________________________
  15.  
  16. State/Province:__________________ Postal/Zip 
  17. Code:___________________
  18.  
  19. Phone:(_____)______-_________ Country:__________ 
  20. Member #:___________
  21.  
  22. Payment Methods (Credit Card ONLY)
  23. [ ]MasterCard [ ]Visa [ ]American Express [ ]Discover
  24. Credit Card 
  25. Number:_______________________________Expiration 
  26. date:______/______/______
  27.  
  28. Signature:________________________________
  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. Shareware Titles ordered
  37. Fees: $3.00(US) per program/minimum order of 5 programs
  38. Part Number - Program Name
  39. ____________-______________________________________
  40.  
  41. ____________-______________________________________
  42.  
  43. ____________-______________________________________
  44.  
  45. ____________-______________________________________
  46.  
  47. ____________-______________________________________
  48.  
  49. ____________-______________________________________
  50.  
  51. ____________-______________________________________
  52.  
  53. ____________-______________________________________
  54.  
  55. ____________-______________________________________
  56.  
  57. ____________-______________________________________
  58. Subtotal $_____________
  59. Sales Tax $____________ (7.75% - CA residents only)
  60. Shipping $_____________ (Charges $4.95(US)/$7.75 
  61. (International)) Total $________________