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Text File  |  1995-01-04  |  2.1 KB  |  62 lines
  1.  
  2.     Internet-Connect(TM) Version 1.1 & 2.0 Mail Order Form
  3.  
  4. Ship to
  5.    Name:________________________________________ 
  6.  
  7. Company:________________________________________ 
  8.  
  9. Address:________________________________________
  10.  
  11.    City:________________________________________
  12.  
  13.   State:___________________ Zipcode:____________
  14.  
  15. Country:________________________________________
  16.  
  17.  
  18. Media Format: [ ] 3.5"     [ ] 5.25"
  19.  
  20. -----------------------------------------------------------------
  21. | Qty.|       Description                 | Unit Price |  Total |
  22. -----------------------------------------------------------------
  23. |     | Internet-Connect V2.0 for Windows | $ 89.00    |        |
  24. |     | Internet-Connect V1.1 for Windows | $ 69.00    |        |
  25. |     |                                   |            |        |
  26. |     | California or Virginia resident   |            |        |
  27. |     |    California 8.25% state tax     |            |        |
  28. |     |    Virginia 4.5% state tax        |            |        |
  29. |     |                                   |            |        |
  30. |     | Shipping & Handling*              |            |        |
  31. |     |    3-Days Priority                |   10.00    |        |
  32. |     |    Federal Express/UPS (next day) |   22.00    |        |
  33. |     |                                   |            |        |
  34. =================================================================
  35.                                                      TOTAL: 
  36.  
  37. * All shipping charges shown are for Continental US only. Price
  38. per package. (Please contact Core Systems (tel/fax 510-9435765
  39. or email lvuong@cais.com) for international shipping).
  40.  
  41. __Check enclosed. (Please make check payable to Core Systems.)
  42.  
  43. Charge to my    __VISA       __MASTERCARD
  44.  
  45. Account Number  _________________________________
  46.  
  47. Expiration Date _________________________________
  48.  
  49. Name on card    _________________________________
  50.  
  51. Signature       _________________________________
  52.  
  53. Telephone       _________________________________
  54.  
  55. Please enclose payment and send this form to:
  56.  
  57.     Core Systems
  58.     PO Box 31022
  59.     Walnut Creek,
  60.     CA 94598 USA
  61.  
  62.