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Text File  |  1999-05-03  |  1.6 KB  |  57 lines
  1.  
  2. PLEASE LOOK AT "HOW TO ORDER" (order.htm) FOR
  3. CASH, CHEQUE OR BANK ORDERS!
  4.  
  5. ***********************************************************
  6. CREDIT CARD ORDER FORM FOR ITEM #30398 1stNote
  7. To:  PsL, Inc. 
  8. Online order http://www.arclab.com/products/1stnote/order
  9. EMail order: 30398@pslweb.com
  10. Fax: (USA) 713-524-6398 
  11.  
  12. Credit card fax order for Item #30398
  13. 1stNote by arclab software GdbR
  14.  
  15. We accept MC, Visa, Amex, Discover
  16.  
  17. ______ 1 computer    @ $20 
  18.  
  19. ______ 2-15 computer    @ $15
  20.  
  21. Shipping and Handling: 
  22. (  ) No shipping - email it. (no disk will be sent)
  23. (  ) send via mail $5 (includes 3,5"disk)
  24.  
  25. (Please do not use any umlauts or characters with accents or 
  26. diacritical marks.)
  27.  
  28. First/Middle Name:__________________________________________
  29.  
  30. Last Name: _________________________________________________
  31.  
  32. Company name: ______________________________________________
  33.   
  34. Address:____________________________________________________
  35.  
  36. City: ______________________________________________________
  37.  
  38. State/Province: _______________________ (U.S. & Canada only)
  39.  
  40. Zip, Country: ______________________________________________
  41.  
  42. Phone # ____________________________________________ (voice)
  43.  
  44. Your email address: ________________________________________
  45.  
  46. BANK name and phone number:_________________________________
  47.  
  48. Credit card number: ________________________________________
  49.  
  50. Expiration: ________________________________________________
  51.  
  52.  
  53.  
  54. Date: ____________  Signature:______________________________
  55.  
  56. PsL is a credit card order service, not the publisher!
  57. Author: arclab GdbR  www.arclab.com  office@arclab.com