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/ Cream of the Crop 21 / Cream of the Crop 21 (Terry Blount) (October 1996).iso / business / auto2u.zip / REGISTER.FRM < prev    next >
Text File  |  1996-07-20  |  2KB  |  66 lines
  1.                                 Order Form:
  2.  
  3. Remit To:
  4. Pc-DsD Software Company 
  5. 1254 Elden Avenue
  6. Los Angeles,Ca.90006
  7.  
  8.  
  9. Phone Orders to: 1-213-507-9679
  10.                  2-213-384-5960
  11.  
  12.  
  13. Date:______________________
  14.  
  15. From:
  16. Name:__________________________________
  17.  
  18. Add1:__________________________________
  19.  
  20. Add2:__________________________________
  21.  
  22. City:__________________________________  St:___  Zip:____________
  23.  
  24. Phone:_____________________
  25.  
  26. Qty                                                      Unit $    Total $
  27.  
  28. ______  AUTO REPAIR PROGRAM .V.2.0 ................(R)   $28.50  $ _______
  29.  
  30. ______  PCMDS OBRA SOFTWARE...(August 92)..Ver 2.3.(R)  $275.00  $ _______
  31.  
  32. ______  Quality Management System (8/91)...Ver.3.0.(R)  $175.00  $ _______
  33.  
  34. ______  LVN2 UNIVERSAL PRECAUTIONS .(8/92).Ver.2.3.(R)  $ 38.50  $ _______
  35.         (CEU'S CREDIT AVAILABLE)
  36.  
  37. ------  LVN MEDICAL/SURGICAL REVIEW ..8/91.(R).Ver.2.1  $ 22.50  $ _______
  38.  
  39. ------  CNA NURSE ASSISTANT REVIEW PROGRAM..Ver.2.1..   $ 22.50  $ _______
  40.  
  41. ------  CPR BYSTANDER REVIEW PROGRAM.(8/91).Ver.2.1..   $ 22.50  $ _______
  42.  
  43. ------  FYI2 - THE BOSS PERSONAL RECORD KEEPER.Ver.2.2  $ 59.50  $ _______
  44.              (FOR YOUR EYES ONLY)   8/92
  45.  
  46. ------  FYI - RESUME WRITER/ADDRESS BOOK ..Ver.2.3......$ 37.50  $ _______
  47.  
  48.  
  49. Shipping   US Canada  Add $ 4.00                                 $ _______
  50.            Overseas   Add $20.00
  51. Taxes      Add 8.25%                                             $ _______
  52.  
  53.                                                         Total    $ _______
  54.  
  55.  
  56. Diskette Size: [ ] 5.25 inch  [ ] 3.5 inch
  57.  
  58. You may fax you order to us at 213-388-0068 !
  59.  
  60.  
  61.  
  62. Signature:_________________________________________________
  63.  
  64. Thank you for your order!
  65.  
  66.