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Text File  |  1993-04-26  |  1KB  |  37 lines
  1.         SUPERMANual Order Form
  2.  
  3.         Please fill out this form with the appropriate information.
  4.  
  5.           Name:  _________________________________________________________
  6.  
  7. Address Line 1:  _________________________________________________________
  8.  
  9. Address Line 2:  _________________________________________________________
  10.  
  11.  City, St, Zip:  _________________________,   __________    ______________
  12.  
  13.  List your Programming Languages: ________________________________________
  14.  
  15.  _________________________________________________________________________
  16.  
  17.  _________________________________________________________________________
  18.  
  19.  Where did you here about SUPERMANual? ___________________________________
  20.  
  21.  Item                             Quantity    Total Price
  22.  
  23.  The SUPERMANual $69ea            ________    ____________
  24.  
  25.  ______________________________   ________    ____________
  26.  
  27.  Disk Size  [ ] 5.25               S & H      __$5.00_____
  28.  
  29.             [ ] 3.5                Total      ____________
  30.  
  31.  
  32.                Send completed order form with your check to:
  33.  
  34.                           Auto-Jock - SM
  35.                           18 8th Street
  36.                           Wheeling, WV  26003
  37.