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Text File  |  1992-05-24  |  2KB  |  46 lines
  1.  
  2.  
  3.                              QwkMan Order Form
  4.                              =================
  5.                                                             
  6.           Name:________________________________________________
  7.                First               Last
  8.  
  9.           Address:_____________________________________________
  10.                   Number            Street            Apt.
  11.  
  12.           City:________________________ State:____  Zip:_______
  13.  
  14.  
  15.           Phone:____________________      _____________________
  16.                 Voice                     Data
  17.  
  18.           Where did you obtain QwkMan?_________________________
  19.  
  20.           _____________________________________________________
  21.  
  22.           Comments:____________________________________________
  23.  
  24.           _____________________________________________________
  25.  
  26.           _____________________________________________________
  27.  
  28.           _____________________________________________________
  29.  
  30.  
  31.                                                                 Cost
  32.                                                                ------
  33.           ( ) Yes, I'd like to register QwkMan.                $15.00
  34.             
  35.           ( ) Please send me the latest version of QwkMan.      $5.00
  36.  
  37.  
  38.                                             Total enclosed: _________
  39.  
  40.  
  41.           Mail to:
  42.           --------
  43.  
  44.               Keith Brown
  45.               19431 Rue De Valore #54B
  46.               Foothill Ranch, CA 92610