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Text File  |  1996-08-03  |  2KB  |  51 lines
  1.  
  2.   Disk Drive Cleaner Order Form
  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. Software registration.
  19.  
  20. (    ) Software (includes one 3 1/2" cleaner kit) $16.50  - - -  _______.____
  21.  
  22.  
  23. (    ) Software (includes one 5 1/4" cleaner kit) $16.50  - - -  _______.____
  24.  
  25. Additional cleaner kits available with registered software only.
  26.  
  27. (    ) 3 1/2" special cleaner kits at $6.50 each  - - - - - - -  _______.____
  28.  
  29.  
  30. (    ) 5 1/4" special cleaner kits at $6.50 each  - - - - - - -  _______.____
  31.  
  32.  
  33.                                                   Subtotal     $________.____
  34.  
  35.  
  36. California residents add 7.25% sales tax on subtotal - - - - -   _______.____
  37.  
  38. Shipping and handling per order add $3.50 for USA, 
  39. Canada and Mexico add $4.75. Others add $5.50  - - - - - - - -      ____.____
  40.  
  41.  
  42. Please pay by check or money order in US funds,  -   Total     $________.____
  43. drawn on US banks, Visa or Master Card.
  44.  
  45.  
  46. ________________________ ________________________ _____________
  47. card holder name         Visa/MC number           Expr. date
  48.  
  49. Please! How did you learn of this product?
  50. (ver. 08/03/96)
  51.