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Text File  |  1996-10-07  |  2KB  |  62 lines
  1. Please fill the form below and send it to PsL by
  2.  
  3. Email :  CompuServe 71355,470  (INTERNET  71355.470@compuserve.com)
  4.          Send a message with the subject "BALLOONS REGISTRATION"
  5.          and the form below as the body of the message. 
  6.  
  7. FAX:     Send form to 713-524-6398
  8.  
  9. Mail:    Print form and send to:
  10.          PsL
  11.      P.O. Box 35705
  12.      Houston, TX 77235,5705
  13.      USA
  14.  
  15.  
  16.             (Form begins below this dotted line)
  17. ...............................................................
  18.  
  19.                REGISTRATION FORM
  20.  
  21.             Product #       14886
  22.             Program name:   BALLOONS
  23.             Author:         Eugenio Garcia
  24.     **************************************************
  25.  
  26.  
  27. Name:_________________________________________________________
  28.  
  29. Street address:_______________________________________________
  30.  
  31. ______________________________________________________________
  32.  
  33. City:________________________ State (Province):_______________
  34.  
  35. ZIP Code:_______________  Country:_____________________
  36.  
  37. Credit Card: ( ) VISA;                  ( ) American Express
  38.          ( ) Master Charge;         ( ) Discover
  39.  
  40. Credit Card Number:________________________Expiration Date:_________
  41.  
  42. Signature______________________________________
  43.  
  44.  
  45.     **************************************************
  46.  
  47.  
  48. Price of the Balloons program:              $ 14.00
  49. Shipping & Handling (worldwide):            $  5.00
  50.                        ...................
  51. Cost including S&H                          $ 19.00
  52. Quantity                                   x ( 1 )
  53.                        ...................
  54. Total Cost                                  $ 19.00
  55.  
  56.  
  57. Sales tax will be added for residents of Texas: 8.25%
  58.  
  59. Check disk size preferred:  (X) 3.5" 1.44MB disk;
  60.                 ( ) 5.25" 1.2MB disk
  61.  
  62.