home *** CD-ROM | disk | FTP | other *** search
/ PC Shareware 1997 February / PC Shareware 1997-02.iso / programy / ize / ize.exe / FILE / DATA / Order.txt < prev    next >
Text File  |  1996-07-14  |  2KB  |  63 lines
  1. ==================| Ize Version 2.04 Order Form |===================
  2.  
  3. ********************************************************************
  4. *                  We accept Visa and MasterCard                   *
  5. *      For immediate registration, please call (719) 595-0367      *
  6. ********************************************************************
  7.  
  8. Name: ______________________________________________________________ 
  9.  
  10. Street Address: ________________________________________ Apt. ______
  11.  
  12. City: _________________________________ State / Province: __________ 
  13.  
  14. Zip / Postal Code: _______________ Country (if not U.S.): __________
  15.  
  16. Phone: ___________________ E-Mail Address: _________________________
  17.  
  18.  
  19. Where did you obtain your copy of Ize? _____________________________
  20.  
  21. ____________________________________________________________________
  22.  
  23.  
  24. Comments or suggestions related to Ize: ____________________________
  25.  
  26. ____________________________________________________________________
  27.  
  28.  
  29. --------------------------------------------------------------------
  30.  QTY.  |        DESCRIPTION          | UNIT PRICE | EXTENDED PRICE
  31. --------------------------------------------------------------------
  32.   1    |     Ize Registration        |    $5.00   |     $5.00
  33. --------------------------------------------------------------------
  34.   Overseas postage (if applicable)   |    $1.00   |
  35. --------------------------------------------------------------------
  36.                                      |    TOTAL   |     
  37.                                      -------------------------------
  38.  
  39. Payment Method:
  40.  
  41. [ ] Check   [ ] Money Order   [ ] Cash   [ ] Visa   [ ] MasterCard
  42.  
  43. If remitting payment by Visa or MasterCard, please provide the
  44. following information:
  45.  
  46. Card Number: ____________________________ Expiration Date: _________
  47.  
  48. Name as it appears on Card: ________________________________________
  49.  
  50. ***  Make checks or money orders drawn on a U.S. bank and payable in
  51.      U.S. funds to GadgetWare.
  52.  
  53. MAIL YOUR PAYMENT AND THIS ORDER FORM TO:
  54.  
  55.                           GadgetWare
  56.                           Attn: Ize
  57.                           PO Box 2536
  58.                           Pueblo, CO  81004-0536
  59.                           USA
  60.                           Telephone: (719) 595-0367
  61.  
  62. Thank you for your order!
  63.