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ORDER.FRM
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1993-04-20
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3KB
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56 lines
┌─────────────────────────────────────────────────────────────────────────┐
│ Invoice │
│ Exhibit A Communications │
│ ┌─────────────────────┐ │
│ │ ReadRoom Door, v2.0 │ │
└──────────────────────┴─────────────────────┴────────────────────────────┘
Qty. Cost/unit Total
______ 15.00 (US) $________
Please make checks payable to Exhibit A.
Mail to: EXHIBIT A COMMUNICATIONS
REGISTRATIONS: READROOM DOOR
110 EAST AVENIDA PALIZADA SUITE 201
SAN CLEMENTE CA 92672
To register using your Visa or MasterCard, please fill out the following:
Card: _____________ Card Number: ____________________________ Exp: ______
Name as it appears on the card: _________________________________________
I understand that my credit card will be charged the amount of $15.00 (US)
and that said charge will appear as being billed by LAW OFFICES OF GERALD
R. GIBBS.
Signature: ___________________________________________ Date:_____________
If registering by credit card, form may be uploaded to InfoMat BBS at (714)
492-8727 or faxed to (714) 492-3697.
Or register online with CompuServer. Just GO SWREG at any prompt.
Please specify delivery method ( ) Mail ( ) Upload to my BBS
┌──────────────────────────┐
│ Registration Information │
└──────────────────────────┘
Your Name :_________________________________________________
BBS Name :_________________________________________________
BBS Phone :(____)_____-__________
BBS Type :( )GAP ( )PCBoard ( )WildCat! ( )Other_____________________
Voice phone:(____)_____-__________
Where did you get this copy of ReadRoom Door? ____________________________
Ship to: _____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
Comments: _____________________________________________
_____________________________________________
_____________________________________________
Any additional comments, suggestions or idle threats on back of
this page.