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Text File  |  1992-09-17  |  2KB  |  59 lines
  1.  
  2.  
  3.                            REGISTRATION / ORDER FORM
  4.  
  5.                             MATH-SHOP 1 (whole #'s)
  6.                             MATH-SHOP 2 (fractions)
  7.                             MATH-SHOP 3 (decimals)
  8.  
  9.                                   Jack C Webb
  10.                                   P.O. Box 357
  11.                          Grand Blanc, Michigan 48439-0357
  12.  
  13.  
  14.        Item                       Quantity  Version   Price     Extension
  15.        ------------------------------------------------------------------
  16.  
  17.        INDIVIDUAL REGISTER/ORDER
  18.          MATH-SHOP 1                  ___     ___     $10.00   $_________
  19.          MATH-SHOP 2                  ___     ___     $10.00   $_________
  20.          MATH-SHOP 3                  ___     ___     $10.00   $_________
  21.          Any two                      ___             $15.00   $_________
  22.          All three                    ___             $20.00   $_________
  23.  
  24.        SCHOOL / INSTITUTION
  25.          REGISTER/ORDER PER SITE
  26.           MATH-SHOP 1                 ___     ___     $25.00   $_________
  27.           MATH-SHOP 2                 ___     ___     $25.00   $_________
  28.           MATH-SHOP 3                 ___     ___     $25.00   $_________
  29.           Any two                     ___             $35.00   $_________
  30.           All three                   ___             $50.00   $_________
  31.  
  32.  
  33.         If ordering please indicate
  34.         disk size and include $1.50                 P & H      $_________
  35.         for postage & handling
  36.         (for each set of 1 to 3 disks)              Total      $_________
  37.  
  38.  
  39.         Disk size:  ___ 5.25  ___ 3.5
  40.  
  41.         Please indicate above the versions you currently have.
  42.  
  43.  
  44.           Please make checks payable to:  Jack C Webb
  45.  
  46.  
  47.           Registrant Name________________________________________________
  48.  
  49.           Address________________________________________________________
  50.  
  51.           Address________________________________________________________
  52.  
  53.           City_______________________________State___________Zip_________
  54.  
  55.           Phone (______)_____________________________
  56.  
  57.  
  58.         From what catalog was program obtained ___________________________
  59.