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/ Informática Multimedia 1995 April / Informatica Multimedia CD - Epimundo.iso / DOS / FILE_CHG / CUTEM.ZIP / ORDER.FRM < prev   
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  1.  
  2.                                    ORDER FORM
  3.  
  4.  
  5. TO:  Mentor Systems
  6.      Box 158
  7.      Clarksville, Mo. 63336
  8.  
  9.  
  10.             Name __________________________________________________________
  11.        Firm Name __________________________________  Phone ________________
  12.          Address __________________________________________________________
  13.             City _________________  State ___  Zip _______  County ________  
  14.    Computer Type __________________________________________________________
  15. I acquired this shareware from ____________________________________________
  16.  
  17. Please register me as a user and send...
  18.  
  19. -----------------------------  Log'Em Products  ---------------------------
  20.  _____ Single User Use License for Log'Em   (@  15.00),  totaling   $______
  21.  _____ Commercial  Use License for Log'Em   (@  75.00),  totaling   $______
  22.  _____ Large Qty.  Use License for Log'Em   (@ 250.00),  totaling   $______
  23.  
  24. -----------------------------  Cut'Em Products  ---------------------------
  25.  
  26.  _____ Single User License for Cut'Em  (excludes disk)
  27.                                            (@  10.00),  totaling   $______
  28.  _____ Copies of Cut'Em diskette  (includes single user license)
  29.                                            (@  15.00),  totaling   $______
  30.  
  31.  
  32.             [] 3 1/2 Diskette     [] 5 1/4 Diskette
  33.                                                    Total Order   $______
  34.   4.225 % Sales Tax (If Missouri Resident)                 Tax   $______
  35.  
  36.  
  37.                                                  TOTAL ENCLOSED  $______
  38.  
  39. Terms: Check with order. Major corporation Purchase Orders accepted. 
  40. We pay shipping (as it should be!)
  41.  
  42. License purchasor agrees to the terms of the License, Disclaimer, and 
  43. Agreement found in the product documentation.
  44.  
  45. COMMENTS: (especially about our products or new software tools you need)
  46. ______________________________________________________________________________
  47. ______________________________________________________________________________
  48. ______________________________________________________________________________
  49. ______________________________________________________________________________
  50. ______________________________________________________________________________
  51. ______________________________________________________________________________
  52.  
  53.                                    Thank You!