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Text File  |  1998-05-18  |  2.1 KB  |  49 lines
  1. Order Form
  2.  
  3.            
  4.             REGISTRATION/ORDER FORM FOR HOLIDAYS SHAREWARE     
  5.        
  6.  
  7.     Your Name: _____________________________________________________
  8.  
  9.     Address:   _____________________________________________________
  10.  
  11.     City:      _____________________________________________________
  12.  
  13.     Province/State:___________________  Postal Code/ZIP: ___________
  14.  
  15.     e-mail address:_________________________________________________
  16.  
  17.    _________________________________________________________________
  18.  
  19.  
  20.     Programs ordered:
  21.     Holidays Series
  22.     [ ]  Valentines Day--Valentine Hunt...........................................$10.00
  23.     [ ]  St. Patrick's Day--The Leprechaun's Gold.................................$10.00
  24.     [ ]  Easter--Easter Egg Hunt..................................................$10.00
  25.     [ ]  Canada Day--Canada Crest Quest...........................................$10.00
  26.     [ ]  Thanksgiving--Thanksgiving Cornucopia....................................$10.00
  27.     [ ]  Halloween--Halloween Trick or Treat......................................$10.00
  28.     [ ]  Remembrance Day--The Soldiers Return.....................................$10.00
  29.     [ ]  Christmas--Christmas Morning Gifts.......................................$10.00
  30.     [ ]  Birthday--Birthday Cake..................................................$10.00
  31.     [ ]  Book Week--Library Book Search...........................................$10.00
  32.     [ ]  UN Day--Flag Find........................................................$10.00
  33.  
  34.     Special package offer:
  35.     [ ]  All of the above programs   (CD of programs).............................$50.00
  36.     [ ]  Licence for Board-wide use of all programs..............................$200.00
  37.  
  38.     [ ] Check enclosed   [ ] Money order enclosed
  39.  
  40.     [ ] School Purchase Order Number:__________________
  41.  
  42.  
  43.                 .................................
  44.                 :  R. Jacob                     :
  45.     Send To:        :  17 Regis Place               :
  46.                 :  London, Ontario              :
  47.                 :  N6K 2G6                      :
  48.                 :..................Canada.......:
  49.