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Text File  |  1990-12-31  |  3KB  |  40 lines
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  2. ┌──────────────────────────────────────────────────────────────────────────┐
  3. │                              CODON SOFTWARE                              │
  4. │                           157 - 10 46th Avenue                           │
  5. │                            Flushing, New York                            │
  6. │DATE:____________                 11355                    (718) 353-3243 │
  7. ├─────────────┬┬┬──────────────────────────────────────────┬┬┬─────────────┤
  8. │             │││ ORDER FORM - REGENTS TUTOR (C) 1987/1988 │││             │
  9. ├─────────────┴┴┴─────────────────────┬────────────────────┴┴┴─────────────┤
  10. │SHIP TO:                             │BILL TO: (If different than ship to)│
  11. │Name/Position:______________________ │Name/Position:______________________│
  12. │                                     │                                    │
  13. │School:_____________________________ │School:_____________________________│
  14. │                                     │                                    │
  15. │Address:____________________________ │Address:____________________________│
  16. │                                     │                                    │
  17. │City:_______________________________ │City:_______________________________│
  18. │                                     │                                    │
  19. │State/Zip:__________________________ │State/Zip:__________________________│
  20. ├─────────────────────────────────────┴────────────────────────────────────┤
  21. │┌────────────────────────────────────────────────────────────────────────┐│
  22. ││               [  ] DISTRICT LICENSE (5 SCHOOLS MAX.) * - - - - $150.00 ││
  23. ││ CHECK ONE ... [  ] LIMITED LICENSE (SINGLE SCHOOL) - - - - - - $120.00 ││
  24. ││               [  ] INDIVIDUAL COPIES ** - - - - - - - - - - - - $35.00 ││
  25. ││                                                                        ││
  26. ││ *  FOR DISTRICTS WITH MORE THAN FIVE SCHOOLS, PLEASE CALL.             ││
  27. ││ ** NOT FOR INSTITUTIONAL USE.                                          ││
  28. │└─────────────────────┬────────────────┬─────────────────┬───────────────┘│
  29. │ EARTH SCI 4 DISK SET │ PRICE $___.00  │ # OF COPIES____ │ TOTAL $____.00 │
  30. ├──────────────────────┼────────────────┼─────────────────┼────────────────┤
  31. │ BIOLOGY - 4 DISK SET │ PRICE $___.00  │ # OF COPIES____ │ TOTAL $____.00 │
  32. ├──────────────────────┴────────────────┴─────────────────┴────────────────┤
  33. │                                                        SHIPPING $   4.00 │
  34. ├──────────────────────────────────────────────────────────────────────────┤
  35. │                 NEW YORK STATE RESIDENTS, PLEASE ADD SALES TAX: $____.__ │
  36. ├──────────────────────────────────────────────────────────────────────────┤
  37. │                                                     TOTAL COST: $____.__ │
  38. └──────────────────────────────────────────────────────────────────────────┘
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