home *** CD-ROM | disk | FTP | other *** search
/ APDL DTP 4 / APDL_DTP4.iso / shareware / grin / order_frm < prev    next >
Encoding:
Text File  |  1998-03-22  |  1.6 KB  |  43 lines
  1. REMIT TO:
  2.  
  3. Grin Graphics
  4. Route 8, Box 129
  5. Jacksonville, TX  75766
  6.  
  7. Voice Phone 903/586-6150  Bulletin Board 903/589-0042
  8.  
  9. Place an X or fill in appropriate spaces................
  10.  
  11.  __ ORDER GRIN GRAPHICS VOLUME #1 COMPLETE SET $18.00 + $2.00 S/H = $20.00
  12.  
  13.  __ ORDER GRIN GRAPHICS VOLUME #2 COMPLETE SET $18.00 + $2.00 S/H = $20.00
  14.  
  15.     Which program format Type?    PCX______     WPG_____
  16.  
  17.     disk size? 5 1/4_____   3.5_______
  18.  
  19. PLEASE NOTE: U.S. FUNDS PLEASE OUT OF U.S.of A. add $10.00
  20.  
  21. Please send my diskettes to:
  22. Name:___________________________________________________
  23. Address:________________________________________________
  24. City:___________________________________________________
  25. State:_________ Zipcode:________________________________
  26. Phone:(not required for cash orders)____________________
  27.  
  28.  
  29. If ordering via credit card: Voice, Bulletin Board, or this form.
  30. Type Card? (Visa, Mastercard)____________________________________
  31. Name as it appears on card.______________________________________
  32. Card Number: ____________________________________________________
  33. Expiration Date:_________________________________________________
  34. Name of Bank authorizing your card:______________________________
  35. Phone:(required for credit card orders:__________________________
  36. Hours you can be reached at this number:_________________________
  37.  
  38. Comments;________________________________________________________
  39.          ________________________________________________________
  40.          ________________________________________________________
  41.          ________________________________________________________
  42.  
  43.