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REGISTER.TXT
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1993-08-31
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2KB
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POWERTIME 1.00 ORDER FORM
-------------------------
NuIQ Software, Inc.
Post Office Box 832
Larchmont, New York 10538 USA
Tel: (914) 833-3479 Fax: (914) 833-3623
Quantity Description Each Total
-------- ----------- ---- -----
_______ PowerTime Chart Program $15 _____
Shipping And Handling:
$5 first item, $2 each add'l in USA 48 States
$12 first item, $2 each add'l in AK, HI, PR, VI,
GU, AS, FPO, APO and Canada
$24 first item, $4 each add'l overseas _____
SALES TAX:
NY residents add sales tax for your county _____
TOTAL _____
If ordering by check, please make checks payable to: NUIQ SOFTWARE INC.
If you would like to order by credit card, orders may be placed
by telephone at 914-833-3479 or by fax at 914-833-3623.
For mail orders by credit card, please complete the following
information:
Cardholder: ______________________________________________________
Card Type: VISA / MASTERCARD / DINERS CLUB / CARTE BLANCHE
Card Number: ______________________________________________________
Expiration: ______________________________________________________
Signature: ______________________________________________________
Date: ___/___/_____
Name: ______________________________________________________
Company: ______________________________________________________
Address: ______________________________________________________
______________________________________________________
Phone: ______________ Fax: ____________ BBS: _______________
Disk Type: 5.25" _____________ or 3.5" _____________
How did you hear about PowerTime:
___________________________________________________________________
___________________________________________________________________
Comments:
___________________________________________________________________
___________________________________________________________________