home *** CD-ROM | disk | FTP | other *** search
/ Cream of the Crop 21 / Cream of the Crop 21 (Terry Blount) (October 1996).iso / utility / rcr01.zip / ORDER.FRM < prev    next >
Text File  |  1996-08-05  |  1KB  |  43 lines
  1. Rosenthal Conflict Resolver Order
  2.  
  3. To: 
  4.                                 _____________________________________________
  5. Rosenthal Engineering           name and shipping address
  6. P.O.Box 1650
  7. San Luis Obispo, CA USA
  8.                   93406         _____________________________________________
  9.                                 address
  10.  
  11. ** PLEASE TYPE OR PRINT **
  12.                                 _____________________________________________
  13.  
  14.  
  15.  
  16.                                 _____________________________________________
  17.                                 city, state zipcode (country)
  18.  
  19. License registration. Includes "Anyalizer" circuit board.            $99.00
  20.  
  21.  
  22.  
  23. California residents add 7.25% sales tax on subtotal - - - - -   _______.____
  24.  
  25.  
  26. Shipping and handling per order add $5.50 for USA, 
  27. Canada and Mexico add $6.75. Others add $7.50  - - - - - - - -      ____.____
  28.  
  29.  
  30.  
  31. Please pay by check or money order in US funds,   -  Total     $________.____
  32. drawn on US banks, Visa or Master Card.
  33.  
  34.  
  35.  
  36. _________________________ _______________________ _____________
  37. card holder name      Visa/MC number           Expr. date
  38.  
  39. Diskette size (check one) 3 1/2" (   ),   5 1/4" (   )
  40.  
  41. How did you learn of this product?
  42. (ver 08/05/96)
  43.