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Text File  |  1991-05-08  |  1.6 KB  |  53 lines
  1.  
  2.       To order please fill out the following form. 
  3.       
  4.       Date: _____________
  5.  
  6.       Name: _____________________________  
  7.  
  8.       Address: ________________________________________________
  9.  
  10.       City: ___________________________________________________
  11.  
  12.       State: ________________________ Zip: ____________________
  13.  
  14.       Phone  Work: (_____) _____ - ______  Home: (_____) _____ -
  15. ______
  16.       
  17.      
  18. *****************************************************************
  19.       Please indicate diskette format:  [ ] 5.25    [ ] 3.5
  20.      
  21. *****************************************************************
  22.                                                   
  23.       Please write the amount next to your choice.
  24.  
  25.       Please register Holly's Numdrops for $15.00.    
  26.       (You receive Holly's Bignumdrops and 2 pkgs candy.)     [   
  27.   ]
  28.  
  29.       Please register Holly's Numdrops and Holly's Letsdrop
  30.       for $25.00.  (You also receive Holly's Bignumdrops and  [   
  31.   ]
  32.       3 pkgs of candy)                                    
  33.  
  34.       Please register Holly's Letsdrop for $15.00.
  35.       (You also receive a pkg of candy.)                      [   
  36.   ]
  37.       
  38.       Please add $1.00 for 3.5 disk.                          [   
  39.   ]
  40.  
  41.       Illinois residents please add 6.5% Sales Tax.           [   
  42.   ]
  43.  
  44.                               Total sent: __________
  45.  
  46.  
  47.      Please make all checks payable to Zimco.
  48.  
  49.       Mail to:  Zimco
  50.                 514 W. Loucks, #2
  51.                 Peoria, Il  61604
  52.  
  53.       Thank you for supporting the Shareware concept.