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Text File  |  1992-03-07  |  4KB  |  58 lines
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  4.                                  ORDER FORM
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  7.          ┌───────────────────────────────────────────────────────────┐
  8.          │                                                           │
  9.          │            LABEL MAKER 7.05 REGISTRATION FORM             │
  10.          │            ----------------------------------             │
  11.          │                                                           │
  12.          │    [ ]  REGISTRATION FEE ...................... $   22.50 │
  13.          │                                                           │
  14.          │    [ ]  SHIP ON 5.25" DISKETTE ................ $    2.50 │
  15.          │                                                           │
  16.          │    [ ]  SHIP ON 3.50" DISKETTE ................ $    3.50 │
  17.          │                                                 --------- │
  18.          │         SUM OF CHECKED BOXES .................. $         │
  19.          │                                                 --------- │
  20.          │    [ ]  KANSAS RESIDENT ADD 5.75% OF SUM....... $         │
  21.          │                                                 --------- │
  22.          │                                                           │
  23.          │         TOTAL ENCLOSED ........................ $________ │
  24.          │                                                           │
  25.          ├───────────────────────────────────────────────────────────┤
  26.          │                                                           │
  27.          │    Registration for:                                      │
  28.          │                                                           │
  29.          │      Name ........... _______________________________     │
  30.          │                                                           │
  31.          │      Company Name.... _______________________________     │
  32.          │                                                           │
  33.          │      Address ........ _______________________________     │
  34.          │                                                           │
  35.          │      City, State, Zip _______________________________     │
  36.          │                                                           │
  37.          │      Telephone Number _______________________________     │
  38.          │                                                           │
  39.          │      LABEL MAKER Version Number  _______                  │
  40.          │                                                           │
  41.          │      SERIAL NUMBER of Program Currently Using  _______    │
  42.          │                                                           │
  43.          │      I learned about LABEL MAKER from, or found on ....   │
  44.          │                                                           │
  45.          │      ________________________________________________     │
  46.          │                                                           │
  47.          ├───────────────────────────────────────────────────────────┤
  48.          │                                                           │
  49.          │    Make check payable to: Fort's Faceting                 │
  50.          │                                                           │
  51.          │    Mail to: Fort's Faceting                               │
  52.          │             P. O. Box 396                                 │
  53.          │             Manhattan, KS  66502                          │
  54.          │                                                           │
  55.          └───────────────────────────────────────────────────────────┘
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