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/ swCHIP 1991 January / swCHIP_95-1.bin / hry / bugworld / orderbug.tx_ / orderbug.tx
Text File  |  1995-12-09  |  952b  |  34 lines
  1.                 BugWorld Order Form
  2.                 ===================
  3.  
  4.        Name: __________________________________________________
  5.  
  6.     Company: __________________________________________________
  7.  
  8.     Address: __________________________________________________
  9.  
  10.        City: ___________________________ State: _______________
  11.  
  12.     Country: _______________________ Post/Zip Code: ___________
  13.  
  14. Where did you obtain
  15.     the program from:  ________________________________________
  16.  
  17.  
  18. Payments:
  19. =======
  20. Payments must be in US Dollars.
  21.  
  22.    BugWorld .................   $12.00 x ____ copies = $_______
  23.    Overseas shipping.........                 $3.00  + $_______
  24.    Total.....................                          $_______
  25.  
  26. specify your disk size:
  27.                           ____ 5.25" ____ 3.5"
  28.  
  29. Make your check payable to Tzu-Fang Chang, and send it to:
  30.  
  31.      P.O. Box 32003
  32.      San Jose, CA 95152-2003
  33.      USA
  34.