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The Best of Select: Games Special 3
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orderfrm.txt
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1995-03-03
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3KB
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56 lines
REGISTRATION/ORDER FORM
To: ARK ANGLES Phone: (047)588100 or Intl+61-47-588100
P O Box 190 Fax: (047)588638 or Intl+61-47-588638
Hazelbrook NSW 2779 Internet: 100237.141@compuserve.com
AUSTRALIA CompuServe: 100237,141
or: INNOVATIVE THINKING Phone: (047)592145 or Intl+61-47-592145
P O Box 47 Fax: (047)592145 or Intl+61-47-592145
Lawson NSW 2783
AUSTRALIA
Name _________________________________________________________
Company _________________________________________________________
Address _________________________________________________________
Town __________________________ State ________ Code ________
Country _________________________________________________________
Phone ___________________________ Fax ________________________
E-mail _________________________________________________________
Where software seen or obtained _________________________________
Computer: [ ] XT [ ] AT/286 [ ] 386 [ ] 486 [ ] >486
Memory Size: ____________ Hard Disk Size: __________
Drives: [ ] 5¼" 360K [ ] 3½" 720K [ ] 5¼" 1.2M [ ] 3½" 1.4M
Screen: [ ] Mono/Herc [ ] CGA [ ] EGA [ ] VGA [ ] >VGA
Dos Ver# _________ Windows Ver# _________ OS/2 Ver# _________
___________________________________________ _______ ___________
| P R O D U C T / L I C E N S E | Q T Y | P R I C E |
|___________________________________________|_______|___________|
| | | |
|___________________________________________|_______|___________|
| | | |
|___________________________________________|_______|___________|
| | | |
|___________________________________________|_______|___________|
| | | |
|___________________________________________|_______|___________|
| T O T A L | |
|___________________________________________________|___________|
[ ] Bankcard [ ] Mastercard [ ] Visa [ ] Cash/Cheque/Draft
Credit Card No ______ ______ ______ ______ Expiry Date ___/___
Cardholder Name _________________________________________________
Signature _____________________________ Date ____________
Comments: