home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
Shareware Overload Trio 2
/
Shareware Overload Trio Volume 2 (Chestnut CD-ROM).ISO
/
dir37
/
smallmnu.zip
/
ORDER.FRM
< prev
next >
Wrap
Text File
|
1994-06-27
|
1KB
|
31 lines
O R D E R F O R M
Cut here
-----------------------------------------------------------------------------
Name _______________________________________________
Company ____________________________________________
Address Line 1 _____________________________________________________________
Address Line 2 _____________________________________________________________
Phone Number ( ) -
City ______________________________ ST(abbr) __ ZIP _____-____
Check [ ]
Money Order [ ]
( No cash please, it can get lost in the mail!! )
[ ] Small Menu v1.0R $10.00 Quantity ______
[ ] Dos VGA Screen Saver - Scrolling stars (lowered) $3.50 Quantity ______
[ ] Check here if you have the 50% off coupon.
Total $
Total number of items ___________
Send to: Ross Luhmann
1474 120th Ave NW
Coon Rapids, MN 55448-1911
_____________________________________________________________________________
Cut here