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/ Experimental BBS Explossion 3 / Experimental BBS Explossion III.iso / clipart / v1_pcx1.zip / REGFORM.DOC < prev   
Text File  |  1993-02-26  |  2KB  |  62 lines
  1.  
  2. REMIT TO:  
  3.  
  4. Grin Graphics
  5. Route 8, Box 129
  6. Jacksonville, TX  75766
  7.  
  8. Voice Phone 903/586-6150  Bulletin Board 903/589-0042
  9.  
  10. Place an X or fill in appropriate spaces................
  11.  
  12.  __ REGISTER GRIN GRAPHICS VOLUME #1 $15.00 +$2.00 S/H = $17.00 
  13.  __ REGISTER GRIN GRAPHICS VOLUME #2 $15.00 +$2.00 S/H = $17.00 
  14.  __ ORDER GRIN GRAPHICS VOLUME #1 COMPLETE SET $18.00 + $2.00 S/H = $20.00
  15.  __ ORDER GRIN GRAPHICS VOLUME #2 COMPLETE SET $18.00 + $2.00 S/H = $20.00
  16.  __ Order Index: Vol# 1 ___ SASE + $1.00 or Vol# 2 ___ SASE + $1.00
  17.  
  18.     Which program format Type?    PCX______     WPG_____
  19.  
  20.                -={PLEASE NOTE: U.S. FUNDS ONLY}=-
  21.  
  22. Please send my diskettes to:  
  23.  
  24. Name:___________________________________________________
  25.                         
  26. Address:________________________________________________
  27.                                                 
  28. City:___________________________________________________
  29.                              
  30. State:_________ Zipcode:________________________________
  31.                               
  32. Phone:(not required for cash orders)____________________ 
  33.  
  34. From where did you receive Grin Graphics Software?_____________
  35. _______________________________________________________________
  36.  
  37. If ordering via credit card: Voice, Bulletin Board, or this form.
  38.  
  39.  
  40. Type Card? (Visa, Mastercard)____________________________________
  41.  
  42. Name as it appears on card.______________________________________
  43.  
  44. Card Number: ____________________________________________________
  45.  
  46. Expiration Date:_________________________________________________
  47.  
  48. Name of Bank authorizing your card:______________________________
  49.  
  50. Phone:(required for credit card orders:__________________________
  51.  
  52. Hours you can be reached at this number:_________________________
  53.  
  54. Comments;________________________________________________________ 
  55.  
  56.          ________________________________________________________
  57.  
  58.          ________________________________________________________
  59.  
  60.          ________________________________________________________
  61.   
  62.