home *** CD-ROM | disk | FTP | other *** search
/ Shareware Overload Trio 2 / Shareware Overload Trio Volume 2 (Chestnut CD-ROM).ISO / dir44 / evasiv11.zip / ORDERFRM.TXT < prev    next >
Text File  |  1994-10-14  |  2KB  |  46 lines
  1.                   %%% Evasive Maneuvers Registration Form %%%
  2.                                Order Form #A617
  3.  
  4.     Name [Please Print, don't write]:
  5.  
  6.     ______________________________________________________________________
  7.     Address:
  8.  
  9.     ______________________________________________________________________
  10.     City, Province/State:
  11.  
  12.     ______________________________________________________________________
  13.     Country, Postal/Zip Code:
  14.  
  15.     ______________________________________________________________________
  16.  
  17.     Do you wish to be placed on our mailing list for future high-quality
  18.     shareware products?
  19.  
  20.               (  ) Yes!        (  ) No!        (  ) Only Games!
  21.  
  22.     Please select disk type...
  23.  
  24.      (  ) 5.25" 1.2Mb                 (  ) 3.5" 1.44Mb (3.5" Ships better)
  25.  
  26.     .--------------------------------------------------------------------.
  27.     |  Product                                                 |  Total  |
  28.     |----------------------------------------------------------|---------|
  29.     |  Evasive Manuvers                                        |  $15.00 |
  30.     |                                                          |         |
  31.     `----------------------------------------------------------|---------|
  32.     Please send your cheque or money   | Shipping & Handling   |   $2.00 |
  33.     order in US or Canadian dollars    |-----------------------|---------|
  34.     payable to "Chris Blackwell" to:   | Outside of North      |         |
  35.                                        | America, please add   |         |
  36.         Exaggerated Software           | an additional $2.00.  |         |
  37.          c/o Chris Blackwell           |---------------------------------|
  38.          238 Renforth Drive            | Total amount payable  |         |
  39.          Etobicoke, Ontario            | to: "Chris Blackwell" |         |
  40.            Canada M9C 2K9              `---------------------------------'
  41.  
  42.     Please allow a couple of weeks for delivery.
  43.  
  44.     Thank you for taking the time to register!
  45.  
  46.