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Text File  |  1994-04-15  |  3KB  |  60 lines
  1.   --------------------------------------------------------------------------
  2.                              ORDER FORM
  3.   --------------------------------------------------------------------------
  4.  
  5.  
  6.  
  7.    Qty   Description                    Price   Total
  8.   +----+-------------------------------+-------+-----+  SHIPPING & HANDLING
  9.   |    |  Tangram                      | $12.00|     |  The shipping charge 
  10.   +----+-------------------------------+-------+-----+  is $3 world-wide.
  11.   |    |  Minefield For Everybody      |  $5.00|     |                     
  12.   +----+-------------------------------+-------+-----+  NOTE: Orders from              
  13.   |    |                               |       |     |    within ISRAEL that
  14.   +----+-------------------------------+-------+-----+    are paid in Sheqels
  15.   |    |                               |       |     |    must add 17% V.A.T.
  16.   +----+-------------------------------+-------+-----+
  17.                      SHIPPING/HANDLING    $3   |  3  |   
  18.                                                +-----+   
  19.                                          TOTAL |     |
  20.                                                +-----+
  21.   Make checks payable to: Judah Warshaw         
  22.   In ISRAEL make checks payable to THE SOFTWARE HOUSE
  23.  
  24.   Disk Size:  ___ 5.25"  ___ 3.5"  (Will use 5.25" if not indicated)
  25.   
  26.   Payment:  _____ Check ____ Money Order   ______ MasterCard ____ Isracard
  27.   
  28.   Card Number:  _______ _______ _______ _______  Expiration Date:  ________
  29.            (NOTE: Minimum Credit Card Order $15.00)
  30.   
  31.   Signature:  _________________________ (credit card orders must be signed)
  32.   
  33.   Name:  __________________________________________________________________
  34.   
  35.   Address:  _______________________________________________________________
  36.   
  37.   City/State/Zip:  ________________________________________________________
  38.  
  39.   Country _________________________________________________________________
  40.   
  41.                   Send to:   Judah Warshaw
  42.                              P.O. Box 27054
  43.                              Jerusalem   91270
  44.                              ISRAEL
  45.  
  46.  
  47.   Where did you get your shareware copy of Tangram?
  48.   
  49.   Catalog Vendor _____________________________________________________
  50.   
  51.   BBS ________________________________________________________________
  52.   
  53.   On-Line Service ____________________________________________________
  54.   
  55.   Friend _____________________________________________________________
  56.   
  57.   Other ______________________________________________________________
  58.   
  59.   ------------------------------------------------------------------------
  60.