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order27.doc
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1996-01-08
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2KB
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58 lines
FED Registration & Order Form
MicroFox Company Date __________________________
PO Box 447
Richfield OH 44286-0447 Telephone Orders (216) 659-9489
USA CompuServe Mail: 73057,3113
FED Registration: $15.00 U.S. each Quantity _____ Amount __________
Multi-User Licenses (check one)
10-User 100-User 500-User 1000-User Unlimited Amount __________
$70 ___ $240 ___ $410 ___ $580 ___ $750 ___
Please include Shipping Charges: $2 USA, $3 Canada, $5 Others __________
Ohio residents:
SubTotal __________ 6.25% Sales Tax ________ TOTAL __________
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
VISA or MasterCard (EuroCard/Access) Number _______________________________
Expiration Date ________ Signature:_______________________________________
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name ___________________________________________ Phone ____________________
Address ___________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
NOTE 1. All prices are in U.S. dollars.
2. Remember to include shipping charges on all orders.
3. Ohio residents, add the state sales tax to the total amount.
4. If paying by credit card, specify the expiration date and sign it.
5. if paying by check, make it payable to MicroFox Company.
USA or Canada: Make checks in U.S. Dollars or equivalent Canadian
Dollars. Other countries: make cheques in your own currency equal
to the U.S. amount. Do -NOT- send cheques in U.S. Dollars if they
not drawn on a U.S. or Canadian bank.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Comments or Suggestions
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________