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Text File  |  1995-02-09  |  1KB  |  50 lines
  1.             
  2.             FINAL EFFECTS™ FAX ORDERING
  3.  
  4. ---------------------------------------------------------------------------------------------------------
  5.  
  6. Hereby I order ___ packages of Final Effects plug-in filters for only 480 USD each. 
  7. (excl. VAT and freight)
  8.  
  9. First name:        ___________________________________________________
  10.  
  11. Last name:        ___________________________________________________
  12.  
  13. Street:        ___________________________________________________
  14.  
  15. ZIP:            ___________________________________________________
  16.  
  17. City:            ___________________________________________________
  18.  
  19. Country:        ___________________________________________________
  20.  
  21. E-mail:        ___________________________________________________
  22.  
  23. Fax:            ___________________________________________________
  24.  
  25. Phone:        ___________________________________________________
  26.  
  27. VAT no:        ___________________________________________________                    
  28. (EC-Countries only)
  29.  
  30. Delivery service:    _____Air        _____DHL              _____Surface
  31.  
  32. Payment:        _____Check         _____Mastercard    _____Visa  
  33.  
  34. Card/Check no:    ___________________________________________________
  35.  
  36. Expire date:        ___________________________________________________
  37.  
  38. Card holders name:    ___________________________________________________
  39.  
  40.  
  41.                 
  42.                 
  43.             _________________     ____________________________
  44.             Date                Signature
  45.  
  46.  
  47.                     UDAC Multimedia
  48.  
  49.             Fax: +46 (18) 516600        Phone: +46 (18) 187778
  50.