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Text File  |  1993-03-14  |  1KB  |  52 lines
  1.                     ORDER FORM
  2.      
  3.      THE COMPLETE EDITIONS HAVE INFORMATION ON ALMOST 2,000 CLUBS IN THE
  4.      US AND IN CANADA-CONSTANTLY UPDATED.  ORDER YOURS TODAY.
  5.                     
  6.      
  7.      NAME:_________________________________________________________
  8.      
  9.      ADDRESS:______________________________________________________
  10.      
  11.      CITY:___________________________________  STATE:_____  ZIP:_______
  12.      
  13.      PHONE: (______)_______-_____________
  14.      
  15.      
  16.      
  17.      SEND ME (Select one or more):
  18.                             QTY           TOTAL
  19.                             
  20.           Printed Editions $17.00 each     _____       $______.___
  21.           
  22.           Diskette Editions $10.00 each    _____       $______.___
  23.           SPECIFY:     ______ 3.5 inch
  24.                    ______ 5.25 inch
  25.                          TOTAL         $______.___
  26.                          
  27.      Enclose a check or money order, payable to O.S.J.G. (U.S. funds
  28.      only) 
  29.                       or charge
  30.      
  31.           _____VISA     _____MasterCard
  32.           
  33.           CARD NUMBER:_______________________________________
  34.           
  35.           EXPIRATION DATE (Mo/Yr):_____/_____
  36.           
  37.           ISSUING BANK:_____________________________________
  38.           
  39.           NAME ON CARD:______________________________________
  40.           
  41.           SIGNATURE:_________________________________________
  42.           
  43.      
  44.      Send to:
  45.                       
  46.                       O.S.J.G.
  47.                       P.O. Box 568
  48.                       Quincy, IL  62306-0568  USA
  49.      
  50.      
  51.      
  52.