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Text File  |  1993-11-09  |  3KB  |  72 lines
  1. Modem Base Pro Release 1.60 Order Form
  2. --------------------------------------
  3. You may use your Credit Card for next day shipping by calling our sales
  4. department at 800-633-6636 (9am-5pm PST) or complete and mail in the form
  5. below to the following address :
  6.  
  7.         Integrated Solutions
  8.         Attention: MODEM BASE PRO SALES
  9.         2995 Van Buren Blvd
  10.         MAIL STOP: A-13-189
  11.         Riverside, CA 92503
  12.  
  13. Make all money orders, cashiers checks, company and personal checks payable
  14. to: INTEGRATED SOLUTIONS
  15.  
  16. ---------------------------------------------------------------------------
  17.    Introductory OFFER Price of $149.00, retail value is $249.00
  18. ---------------------------------------------------------------------------
  19.                     (Offer Good until March 1, 1993)
  20.  
  21. FULL NAME:______________________________________________________________
  22.   COMPANY:______________________________________________________________
  23.   ADDRESS:______________________________________________________________
  24.      CITY:______________________________________________________________
  25.     STATE:______________________________________________________________
  26.   COUNTRY:______________________________________________________________
  27.       ZIP:______________________________________________________________
  28.  
  29. TELEPHONE:_______________________  BBS PHONE:___________________________
  30.       FAX:_______________________   BBS NAME:___________________________
  31.  
  32. SYSOP NAME IF DIFFERENT FROM PURCHASER:_________________________________
  33.  
  34. The following information is optional, but helps assist us in knowing
  35. more about our customer base.
  36.  
  37. BBS SOFTWARE:___________________________________________________________
  38. BBS NAME:_______________________________________________________________
  39.   # OF LINES:_________________   YEARS ON-LINE:_________________________
  40.  
  41. ----------------------------------------------------------------------------
  42. ORDER WORKSHEET:
  43. ----------------------------------------------------------------------------
  44. QUANTITY        PRODUCT                 UNIT COST       EXT.COST
  45. -----------------------------------------------------------------
  46. ___             MODEM BASE PRO 1.6        $149.00
  47.  
  48.                                             SUBTOTAL:
  49.                                             (CA) TAX:
  50.                       FEDERAL EXPRESS 2-DAY SHIPPING:    $12.50
  51.                                                TOTAL:
  52. CA residents add sales tax.
  53. Make Checks payable to: INTEGRATED SOLUTIONS.
  54. (Personal Checks allow up to 2 weeks for delivery, for faster response send
  55. a cashiers check or money order, government purchase orders excepted, call
  56. 800-633-6636 or use your credit card - see below.)
  57.  
  58. I have enclosed the following amount $______________.
  59.  
  60. Credit Card Orders:
  61. -------------------
  62. Which Credit Card?  [ ] VISA    [ ] MASTERCARD
  63.  
  64.    Cardholder:______________________________________
  65. Credit Card #:______________________________________
  66.    Expiration:______________________________________
  67. Please Charge my Credit Card the following amount: $_____________________.
  68.     Signature:______________________________________  Date:______________
  69.  
  70. Please rush me my order of Modem Base Pro Commercial Release.
  71. ----------------------------------------------------------------------------
  72.