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Text File  |  1996-05-19  |  8KB  |  208 lines
  1.    ========================================================================
  2.                       InterCom v3.x registration form
  3.    InterCom is Copyright (c) 1995-96 by Jonathan Tew.  All Rights Reserved.
  4.    ========================================================================
  5.  
  6.    Note: Each registration of InterCom comes with at least two licenses
  7.          for InterCom.
  8.  
  9.    Note: InterCom is distributed via BMT Micro and other companies.
  10.          These companies are in no other way affiliated with Revolutionary
  11.          Software or InterCom.
  12.  
  13.    Note: There is a new company taking registrations for asian and pacific
  14.          countries.
  15.  
  16.                                 ----------
  17.                                 World Wide
  18.                                 ----------
  19.  
  20.                   Mail Orders To: BMT Micro
  21.                                   PO Box 15016
  22.                                   Wilmington, NC  28408
  23.                                   U.S.A.
  24.  
  25.                     Voice Orders: 8:00am - 7:00pm EST (-5 GMT)
  26.                                   (800) 414-4268 (Orders only)
  27.                                   (910) 791-7052 (Orders / Order Inquires)
  28.  
  29.                       Fax Orders: (800) 346-1OS2 (1672) 24 hours, 7 days a week
  30.  
  31.            Online Orders via BBS: (910) 350-8061 10 lines, all 14.4K
  32.                                   (910) 799-0923 28.8k v.FC
  33.  
  34.                   via Compuserve: Thomas Bradford, 74031,307
  35.                     via Internet: orders@bmt.wilmington.net
  36.  
  37.      We accept Visa, Mastercard, Discover, American Express, Diner's Club,
  38.      money order, cashiers checks, and personal checks.  We also accept
  39.      DM and British currency via registered mail.
  40.  
  41.      Personal checks are subject to clearance.
  42.  
  43.      We accept purchase orders from educational institutions, governmental
  44.      agencies and other verifiable businesses.  Terms are "Due Upon
  45.      Receipt" with a $250 minimum.
  46.  
  47.  
  48.         Name: ____________________________________________________________
  49.  
  50.      Company: ____________________________________________________________
  51.  
  52.      Address: ____________________________________________________________
  53.  
  54.               ____________________________________________________________
  55.  
  56.         City: _______________________   State/Province: __________________
  57.  
  58.      Country: ____________________________ Postal Code: __________________
  59.  
  60.        Phone: ____________________________________________________________
  61.  
  62.          Fax: ____________________________________________________________
  63.  
  64.        Email: ____________________________________________________________
  65.  
  66.  
  67.      Product                           Price        Quantity   Total
  68.      --------------------------------------------------------------------
  69.                   ( Funds below specified in US dollars )
  70.  
  71.      _InterCom v3.x__________________  $_29.99__ x  ________ =  $____.___
  72.  
  73.      ________________________________  $________ x  ________ =  $____.___
  74.  
  75.      ________________________________  $________ x  ________ =  $____.___
  76.  
  77.      ________________________________  $________ x  ________ =  $____.___
  78.  
  79.      ________________________________  $________ x  ________ =  $____.___
  80.  
  81.                                                      Subtotal:  $____.___
  82.  
  83.             North Carolina residents, please add 6% sales tax: +$____.___
  84.  
  85.      Shipping (check one):
  86.  
  87.                ___ Email (subject to credit card verification      Free
  88.                ___ Fax   (subject to credit card verification      Free
  89.                ___ 1st Class .................................     Free
  90.                ___ Airborne (Next day most places, USA Only).. +$___7.00_
  91.                ___ Federal Express (USA Only)................. +$__13.00_
  92.                ___ Federal Express (Canada/Mexico)............ +$__25.00_
  93.                ___ Federal Express (Europe/Japan)............. +$__30.00_
  94.                ___ Express (Outside USA) ..................... +$__20.00_
  95.  
  96.                                                         Total:  $____.___
  97.  
  98.      For credit card payment only:
  99.  
  100.        Circle one: VISA / Master / Discover / AMEX / Diner's Club
  101.  
  102.        Credit card number: _____________________________________________
  103.  
  104.           Expiration date: ___/___
  105.  
  106.   Authorization signature: _____________________________________________
  107.  
  108.  
  109.       --- Additional ordering information for our German customers---
  110.  
  111. If you reside in Germany and wish to register InterComm locally you can
  112. deposit the registration fee into our account in Germany.
  113.  
  114. The registration fee using this method is 46 DM diskless / 50 DM with
  115. diskette.
  116.  
  117. Empfanger:  Thomas Bradford
  118. Konto-Nummer: 0860221
  119. Bankleitzahl: 500-700-10
  120.  
  121. After depositing the money, you can fax confirmation of the deposit to
  122. 910-350-2937 along with the registration form -or- you can wait until we are
  123. notified by Deutsche Bank that your deposit has been made, usually within 7-10
  124. days.
  125.  
  126.  
  127.  
  128.                                 -------------------
  129.                                    Asian/Pacific
  130.                                 -------------------
  131.  
  132.                 Mail Orders To: Taiyotech Singapore Pte Ltd
  133.                                 No. 1, Rocher Canal Road
  134.                                 #06-53/31
  135.                                 Sim Lim Square
  136.                                 Singapore 188504
  137.  
  138.                 Voice Orders:   11:00am - 9:00pm
  139.                                 (65) 338-4123 (Orders / Order Inquires)
  140.  
  141.                 Fax Orders:     (65) 336-2376 24 hours, 7 days a week
  142.  
  143.                 via Internet:   taiyo@mailhost.net
  144.  
  145.      We accept Visa, Mastercard, American Express, Diner's Club, money order,
  146.      cashiers checks, and personal checks.  Singapore currency is most welcome.
  147.      Personal checks are subject to clearance.
  148.  
  149.  
  150.      Name:
  151.      ____________________________________________________________
  152.  
  153.      Company:
  154.      ____________________________________________________________
  155.  
  156.      Address:
  157.      ____________________________________________________________
  158.  
  159.      ____________________________________________________________
  160.  
  161.      ____________________________________________________________
  162.  
  163.      City: _______________________   State/Province: __________________
  164.  
  165.      Country: ______________________ Postal Code: __________________
  166.  
  167.        Phone:
  168.        ____________________________________________________________
  169.  
  170.        Fax:
  171.        ____________________________________________________________
  172.  
  173.        Email:
  174.        ____________________________________________________________
  175.  
  176.  
  177.      Product                     Price        Quantity   Total
  178.  
  179.      ---------------------------------------------------------------
  180.  
  181.      Intercom__________       US$29.95___  x  ________ = US$____.___
  182.  
  183.                                               Subtotal:  US$____.___
  184.  
  185.      Shipping (check one):
  186.  
  187.     ___ Email (subject to credit card verification           Free
  188.     ___ Fax   (Singapore                                     Free
  189.     ___ Federal Express (Outside Singapore)........     +US$__10.00_
  190.  
  191.                                                  Total:  US$____.___
  192.  
  193.      For credit card payment only:
  194.  
  195.        Circle one: VISA / Master / AMEX / Diner's Club
  196.  
  197.        Credit card number: _____________________________________________
  198.  
  199.           Expiration date: ___/___
  200.  
  201.   Authorization signature: _____________________________________________
  202.  
  203.   Note: For payment in Singapore dollars, please contact taiyotech for
  204.   exact price.
  205.  
  206.  
  207.  
  208.