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ORDER.FRM
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1992-03-01
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3KB
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64 lines
FDSECURE 2.00 ORDER FORM
===============================================================================
Print and fill out this order form and mail it to:
Registrations: Inquires, Questions & Comments:
Software America, Inc. Software America, Inc.
FDSecure Registration Customer Services - FDSecure
P.O. BOX 690895 1905-B South 116th East Ave.
Tulsa, OK 74169-0895 Tulsa, OK 74128-6417
===============================================================================
INFORMATION
Please type or print legibly
Name:_______________________________________________ Date:____________________
Address:______________________________________________________________________
City:___________________________________ State:____________ Zip:______________
Signature: (required)_________________________________________________________
Network Address:__________________________Network Organization:_______________
===============================================================================
PRODUCT
FDSecure v2.00 Quantity______ X $20.00 = $_______
Sales Tax (Oklahoma Residents only: 7.5%) $_______
Total $_______
===============================================================================
PAYMENT METHOD:
Please check or circle one from below...
[] Personal Check [] MasterCard
[] Company Check [] Discover
[] Visa [] American Express
Credit Card Number: __________________________________________________________
Your name as it appears on your card:_________________________________________
Expiration Date: (MM/YY)_________________________Total Amount:_$______________
Signature: (required)_________________________________________________________
===============================================================================
NOTE
You may also phone in your order if you wish by calling 918-234-8261,
Monday through Friday, 9am to 5pm CST, or FAX your order 24 hours a
day to 918-234-7638. Technical support and questions can be obtained
by calling 918-234-8262 at our regular business hours. You can also
order by calling our BBS and leaving your information at 918-438-8260.
Thank you for supporting the shareware concept.