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Text File  |  1997-11-23  |  2.3 KB  |  47 lines

  1. TRANSFER 95 ORDER FORM (10/15/97)
  2. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
  3. FAX this form toll free to: 888.396.6926 or 612.426.6023
  4. Or E-Mail to: itech@mn.uswest.net
  5. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
  6. Name: ____________________________________________________________
  7. Company: _________________________________________________________
  8. Title: ___________________________________________________________
  9. Address1: ________________________________________________________
  10. Address2: ________________________________________________________
  11. City: _____________________________ State/Province: ______________
  12. Zip/Postal Code: __________________ Country: _____________________
  13. Phone: ___________________________________________________________
  14. FAX: _____________________________________________________________
  15. ** E-Mail Address: _______________________________________________
  16. ** Your email address is not optional.
  17. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
  18. Price    Qty   Description
  19. ==================================================================
  20. $19.95  [    ] Personal Edition                             ______
  21. $NONE   [    ] Upgrade. Serial Number ___________________
  22.  
  23. $69.95  [    ] Professional Edition                         ______
  24. $NONE   [    ] Upgrade. Serial Number ___________________
  25.  
  26. $39.95  [    ] Personal to Professional Upgrade.            ______
  27.                         Serial Number ___________________
  28.  
  29.                                       Processing fee $5.00   $5.00
  30.                                                Total Amount ______
  31.  
  32. Credit Card Type: ( )Visa ( )MasterCard ( )AMEX ( )Discover
  33. Credit Card Number: ________________________________
  34. Exp. Date(MM/YY): ___________
  35.  
  36. Enter the bank's name and phone number from the back of the card
  37. or from your statement.
  38. (Order cannot be processed without this information.)
  39.  
  40. __________________________________________________________________
  41.  
  42. Signature: _______________________________________________________
  43. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
  44. All orders must be prepaid in US Funds Only.
  45. Address & Zip code must match credit card billing address.
  46. All orders are subject to approval.
  47.