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- SILICON CITY ORDER FORM: A001
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- Mail orders to: Lyric Software Company
- 25 Woody Lane
- Northport, NY 11768
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- Phone orders to: (516) 754-5570
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- --------------------------------------------------
- | Description | Price | Total |
- --------------------------------------------------
- | SILICON CITY | $19.00 | $19.00 |
- | Sales Tax (NY Residents) | 1.62 | |
- | Extra shipping outside USA | 3.00 | |
- | Shipping and handling | 3.00 | 3.00 |
- --------------------------------------------------
- TOTAL AMOUNT ENCLOSED: | |
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- Make checks payable to Lyric Software Company.
- Checks must be drawn on a US bank. If ordering
- outside the US, please use a credit card, or a
- postal money order in US Funds.
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- Disk Size: ___ 3.5" ___ 5.25"
- [ ] Check [ ] VISA [ ] Master Card
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- Card Number: _________________________________
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- Expiration Date: _____________________________
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- Signature: ___________________________________
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- Name: ________________________________________
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- Address: _____________________________________
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- City: ________________________________________
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- State/Country: _______________________________
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- Zip/Postal Code: _____________________________
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- I received the SILICON CITY DEMO from:
- [ ] friend [ ] disk vendor [ ] user group
- [ ] free BBS [ ] pay BBS [ ] other
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- If you downloaded the demo from your local BBS,
- we'd like to make a $5.00 contribution to that
- BBS. Please enter the BBS's name and phone
- number, including area code:
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- Name:_________________________________________
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- Phone: (______)______________________________
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- Comments, suggestions:________________________
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- ______________________________________________
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