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  1.  
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  4.                        Limited Edition Collector's Issue
  5.        HyperComix issue # 1 - Lance Stone: Trouble at the Woz order form
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  7.  
  8.  
  9. Name:________________________________________________________________
  10.  
  11. Company:_____________________________________________________________
  12.  
  13. Address:_____________________________________________________________
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  15.         City_________________________________ST_____Zip______________
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  18. Phone #: (____)____________
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  20.  
  21. Method of Payment:  Check_____  VISA_____  MC_____
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  24. Credit Card #______________________________________ Exp._____________
  25.  
  26. Signature (For CC orders)____________________________________________
  27.  
  28.  
  29. Where did you hear about Lance Stone? _______________________________
  30.  
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  32. Product:                                   Each:      Quan:    Price:
  33.  
  34. Issue #1 - Lance Stone: Trouble at the Woz $19.95     _____   _______
  35.  
  36. Evaluation copy - Lance Stone #1  [5.25"]  $5.98      _____   _______
  37.  
  38. Evaluation copy - Lance Stone #1  [3.5"]   $6.98      _____   _______
  39.  
  40.                                                    Subtotal:  _______
  41.  
  42.                                                    Shipping:   $3.00
  43.  
  44.                             Additional shipping (see chart):  _______
  45.  
  46.                                             COD (add $5.00):  _______
  47.  
  48.                                                    TOTAL:     _______
  49.  
  50. --------------------------------------+
  51.         SPECIAL SHIPPING CHART *      +      ORDER TOLL FREE 1-800-723-7638
  52. --------------------------------------+
  53.                                  Add          or return this order form to:
  54. --------------------------------------
  55. UPS Ground - Continental US     $ 2.00
  56. UPS 2nd Day - Cont US           $ 6.00         DIRECT ADVANTAGE SOFTWARE
  57. UPS 2nd Day - AK & HI           $10.00             18 N FRONT STREET
  58. Airborne Express overnight      $10.00           MEDFORD, OR 97501-5903
  59. Canada                          $ 2.00
  60. Other Foreign                   $ 8.00
  61.  
  62.  
  63. * all orders are shipped by 1st
  64.   Class Mail for $3.00 unless                             VISA/MC
  65.   specified on the chart above.
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