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Text File  |  1995-07-04  |  2KB  |  44 lines
  1.  
  2.                                  Order Form
  3.  
  4.  
  5.     Name     ____________________
  6.  
  7.     Address  ____________________    Apartment #  ______
  8.  
  9.     City     ____________________    State        ______   Zip  __________
  10.  
  11.     Country  ____________________
  12.     
  13.     ----------+--------------------------------------------+---------+--------
  14.     QUANTITY  |                PRODUCT                     |  PRICE  |  TOTAL
  15.     ----------+--------------------------------------------+---------+--------
  16.               |  Software: The X-Zone:  A Math Odessey     | $       |
  17.     ----------+--------------------------------------------+---------+--------
  18.               |  Curriculum Guide: Pre-Algebra Concepts    |         |
  19.     ----------+--------------------------------------------+---------+--------
  20.                                       In Florida, add 6.5% sales tax |
  21.     ----------+--------------------------------------------+---------+-------- 
  22.                  TOTAL                                     |         |
  23.     ----------+--------------------------------------------+---------+--------
  24.  
  25.     [ ]  5.25" disk (high density) requested.
  26.     [ ]  I would like information about your gift wrap/shipping service
  27.  
  28.     Make check payable to:
  29.  
  30.     B & W Software
  31.     P.O. Box 128
  32.     Thonotosassa, FL 33592
  33.  
  34.     Shipping address if different from above:
  35.  
  36.     Name     ____________________
  37.  
  38.     Address  ____________________    Apartment #  ______
  39.  
  40.     City     ____________________    State        ______   Zip  __________
  41.  
  42.     Country  ____________________
  43.  
  44.