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ORDER.DOC
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1993-09-27
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3KB
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55 lines
ORDER FORM
For credit card or multiple For cash or cheque orders
product orders send to for DAUB only send to
ARK ANGLES TOPLINE SOFTWARE
24 Alexander Ave P O Box 66
Hazelbrook NSW 2779 Rundle Mall SA 5000
AUSTRALIA AUSTRALIA
Phone: (047) 588100 or Intl+61-47-588100
Fax: (047) 588638 or Intl+61-47-588638
From: Name ______________________________________________________________
Company ______________________________________________________________
Address ______________________________________________________________
Town _____________________________ State _________ Code _________
Country ______________________________________________________________
Phone _____________________________ Fax ___________________________
Where did you obtain the program(s)? _______________________________________
Computer: [ ] XT [ ] AT/286 [ ] 386SX [ ] 386DX [ ] 486 [ ] >486
Memory Size: ____________ Hard Disk Size: __________
Floppies: [ ] 5.25" 360K [ ] 5.25" 1.2M [ ] 3.5" 720K [ ] 3.5" 1.44M
Screen: [ ] Mono [ ] Herc [ ] CGA [ ] EGA [ ] VGA [ ] >VGA
Dos Version: ________ Windows Version: _________ OS/2 Version: _________
_____________________________________________________ ________ ___________
| P R O D U C T / L I C E N S E | Q T Y | P R I C E |
|_____________________________________________________|________|___________|
| | | |
|_____________________________________________________|________|___________|
| | | |
|_____________________________________________________|________|___________|
| | | |
|_____________________________________________________|________|___________|
| | | |
|_____________________________________________________|________|___________|
| Shipping | $5.00 |
|______________________________________________________________|___________|
| T O T A L | |
|______________________________________________________________|___________|
[ ] Bankcard [ ] Mastercard [ ] Visa [ ] Cash/Cheque/Draft/Money Order
Credit Card Number _______ _______ _______ _______ Expiry Date ____ / ____
Cardholders Name _________________________________________________________
Signature _______________________________ Date __________________