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Text File  |  1995-10-08  |  2KB  |  56 lines
  1.                       Order Form for agSI Version 1.1.2
  2.                     ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
  3.  
  4.      (please fill in / check:)
  5.                                                prices each    prices total
  6.  
  7.      ___ x Licence for agSI                DM 20,- / $ 15 * ->  __ _____
  8.            (you will recieve a registration code)               ^ currency
  9.  
  10.      ___ x 3 1/2" Disk with latest version  DM  5,- / $ 4 * ->  __ _____
  11.            default English; [ ] also German, [ ] only German
  12.            [ ] I want 5 1/4 " disk(s)
  13.            outside Europe additionally   1x DM  8,- / $ 6   ->  __ _____
  14.  
  15.      * For discounts on quantity orders, see README or online help!
  16.  
  17.      Payment/Shipping:
  18.      ( )   pre-paid (cash / cheque)                  --             --
  19.      ( )   C.O.D. (only inside Germany!)           DM  5,-  ->  __ _____
  20.      (No credit card orders)
  21.                                                              =============
  22.  
  23.      Total:  ------------------------------------------------>  __ _____
  24.  
  25.      [ ]  Please inform me about "major" upgrades...
  26.           [ ] via e-mail     [ ] via letter
  27.  
  28.      I got agSI from... __________________________________________________
  29.  
  30.      Comments: ___________________________________________________________
  31.  
  32.               ____________________________________________________________
  33.  
  34.      Name:    ____________________________________________________________
  35.      (Please state if you want a different name used for the reg' entry.)
  36.  
  37.      Company: ____________________________________________________________
  38.  
  39.      Address: ____________________________________________________________
  40.  
  41.               ____________________________________________________________
  42.  
  43.               ____________________________________________________________
  44.  
  45.      E-Mail:  ____________________________________________________________
  46.      (accessible from the Internet)
  47.  
  48.  
  49.      Date: __________________   Signature: _______________________________
  50.  
  51.  
  52.      Mail to:  Andreas Groegel           or (C.O.D. delivery) via
  53.                Gildenstr. 4              e-mail (Internet) to:
  54.                D-74074 Heilbronn           ag@studbox.uni-stuttgart.de
  55.                Germany
  56.