home *** CD-ROM | disk | FTP | other *** search
/ TopWare 18: Liquid / Image.iso / liquid / top2060 / order.txt < prev    next >
Text File  |  1994-05-08  |  1KB  |  38 lines
  1.                                 MapIt 1.0 Order Form 
  2.                 Prices listed are for prepaid orders in U.S. funds.
  3.                 Shipping is included.
  4.  
  5.         Item            Quantity    Price    Amount 
  6. New Registration:
  7. Disk size (3.5__ or 5.25___)        ________    $10.00    _______ 
  8.  
  9.  
  10.                             TOTAL   _______
  11. Select Method of Payment:            
  12.                                  
  13. *Check ____ Money Order ____ 
  14. * Checks drawn on Non-U.S. banks or in Non U.S funds 
  15.   cannot be accepted.  Checks must be made payable to Fred Schatzki.
  16.  
  17. Name:       ___________________________________________ 
  18.  
  19. Email:        ___________________________________________ 
  20.  
  21. Address 1    ___________________________________________ 
  22.  
  23. Address 2    ___________________________________________ 
  24.  
  25. City        ________________________  State  _______ ZIP ___________ 
  26.  
  27. Phone (      ) _________ - _________________    (optional)
  28.  
  29. Mail this form with payment to:  
  30.                                     Fred Schatzki 
  31.                                     Rt. 1 Box 41
  32.                                     Hampton, SC 29924
  33.                                     (803) 943-3848 (voice)
  34.  
  35.  
  36.                         Please allow 3 weeks for delivery
  37. 
  38.