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ORDER.TXT
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Text File
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1995-03-29
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3KB
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60 lines
UniVBE Order/Registration Form
SciTech Software ___/___/___
5 Governors Lane, Suite D MM/DD /YY
Chico, CA 95926 USA
Toll free/Phone/Fax: 800-4UNIVBE/916-894-8400/510-208-8026
PLEASE PRINT OR TYPE CLEARLY!
Name: __________________________________________________________________
Company: _______________________________________________________________
Address: _______________________________________________________________
__________________________________Zip/Postal Code______________
______________________________________ Country ________________
Phone: ___________________________________ Fax: _______________________
Email: _________________________________________________________________
Register product(s) to: [ ] Company [ ] Individual
Pay By: [ ] Cheque (USA only) [ ] Money Order [ ] Credit Card
Credit Card Orders: MasterCard / Visa / American Express(circle one):
Card Number ___________________________________ Expires ___/___
Exact name on card (print) ____________________________________
SHIPPING CHARGES: If a disk & manual are ordered from outside of the
USA, the shipping charge is US$7 and will be delivered via airmail.
For orders within the USA, the shipping charge is US$3. Orders without
disk & manual will receive a receipt and registration code via airmail
for no additional shipping charge.
Price List Cost Qty Price
------------------ ------------------ ----- --- ------
Upgrade from UniVBE/Pro 4.x (registered) US$16* ___ $ ______
UniVBE/Pro 5.x US$28* ___ $ ______
Manual + Disk [ ] 3.5" [ ] 5.25" US$10 ___ $ ______
*Includes all 5.x upgrades (available online)
Subtotal: $ ______
CA residents add 7.25% sales tax: $ ______
Shipping Charges (See above for amount!): $ ______
Total Enclosed: $ ______
I have read and agree to abide by the enclosed license agreement and I
agree to be bound by my credit card agreement.
(Signature required) ________________________________________________