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OrderForm.txt
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1998-06-24
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2KB
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62 lines
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Simone Tellini Order form for
Piazza Resistenza 2
42016 Guastalla RE STFax
ITALY
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Dear Simone,
I'd like to register to STFax, please send me my keyfile.
I'd like to receive the keyfile by
( ) Snail Mail
( ) E-Mail (PGP public key needed)
I include the registration fee of
Country | Fee | Method of payment
---------------------------------------------------------
( ) Italy | LIT 45.000 | Contanti, vaglia, assegno
---------------------------------------------------------
( ) Europe | LIT 50.000 | Cash, postal money order,
| | EuroCheques
---------------------------------------------------------
( ) Rest of the | US $ 35 | Cash, postal money order
world | | NO CHEQUES!
---------------------------------------------------------
Name __________________ Surname _________________________
Address _____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Country _____________ Phone Number +___________________
FAX ___________________ E-Mail __________________________
Date __________________ Sign __________________________
Amiga owned: Kickstart: Memory: ___ Mb
( ) 500 ( ) 500+ ( ) 1.3 ( ) 3.0 HardDisk: ___ Mb
( ) 2000 ( ) 3000 ( ) 2.04 ( ) 3.1
( ) 1200 ( ) 4000 ( ) 2.1 Modem
Model: ___________
Baud: ___________
Comments:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________