home *** CD-ROM | disk | FTP | other *** search
/ Power CD-ROM!! 8 / Power CD-ROM 8.iso / windows / mpdiary / order.frm < prev    next >
Text File  |  1994-04-23  |  2KB  |  60 lines
  1.  
  2.                         Order Form For My Personal Diary 
  3.                         ________________________________
  4.  
  5.  
  6. Send to:                                  From: (PLEASE PRINT)
  7.  
  8. Chris Maresco                                  
  9. 105 Bayview Ave.                         ___________________________________
  10. E. Patchogue NY 11772
  11.                                          ___________________________________
  12. (Please write for bulk
  13. discounts and site licenses.)            ___________________________________
  14.  
  15.                                Phone:    ______________________
  16.  
  17.  
  18.  
  19.         
  20.                                          Number Of Copies: _________
  21.                
  22.                                                          X $20.00
  23.  
  24.  
  25.                                          Send This Amount: _________
  26.                                   
  27. Current Version: _____
  28.  
  29. I prefer 5 1/4" ____  3 1/2" ____ Disks.
  30.  
  31. Can you use high density disks? YES ____  NO ____
  32.  
  33. Would you like to receive a mailer? YES ____  NO ____
  34.  
  35. Orders will be shipped promptly, THANK YOU FOR REGISTERING!
  36. ____________________________________________________________________________
  37.  
  38. (Optional questions to help us better understand your needs)
  39.  
  40. My computer is a 286 ____ 386 ____ 486 ____ Pentium ____  Other __________
  41.  
  42. I use my computer for: ENTERTAINMENT  ____  BUSINESS ____ PROGRAMMING ____
  43.                        
  44.                        RECORD KEEPING ____  OTHER ________________________
  45.  
  46. Do you regularly try shareware programs? YES ____ NO ____
  47.  
  48. Suggestions, Comments or Whatever:
  49. (ANY feedback is greatly appreciated, good or bad.)
  50.  
  51. ____________________________________________________________________________
  52.  
  53. ____________________________________________________________________________
  54.  
  55. ____________________________________________________________________________
  56.  
  57. ____________________________________________________________________________
  58.  
  59. ____________________________________________________________________________
  60.