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Text File  |  2002-12-26  |  819 b   |  44 lines

  1.  
  2.             NEED4READING
  3.  
  4.             Order Form
  5.  
  6.  
  7. Name     ______________________________________
  8.  
  9. Address     ______________________________________
  10.  
  11.     ______________________________________
  12.  
  13.     ______________________________________
  14.  
  15. Telephone         (    )______________________________
  16.  
  17. Fax Number      (    )______________________________
  18.  
  19. E-mail     _____________________________________
  20.  
  21. Site Code    ______________________ (Please print clearly)
  22.  
  23.  
  24.  
  25.         Cheque           [   ] 
  26.         Money Order     [   ]
  27.  
  28.         Registration Need4Reading Full Version     A$49.50
  29.  
  30.         Credit Cards
  31.         Call (02) 9214 78 98.
  32.         Please have your Credit card
  33.         and Site Code ready for the operator.        
  34.  
  35.         See Website for details.
  36.         www.need4reading.com
  37.  
  38.         hbruce@tsn.cc 
  39.         Fax (02) 65 838 520
  40.     
  41.         Do not fax your credit details on this form.
  42.         
  43.  
  44.