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Text File  |  1996-09-15  |  1KB  |  42 lines
  1. Order Form
  2.  
  3. This order form is for checks/money orders ONLY.  If you would like to
  4. pay by credit card, please see the README.TXT file.
  5.  
  6. Company:____________________________________________________
  7.  
  8. Name:_______________________________________________________
  9.  
  10. Address:____________________________________________________
  11.  
  12. City:________________________State/Province:________________
  13.  
  14. Zip:_____________________Country:___________________________
  15.  
  16. CompuServe Id:_________________________
  17.  
  18. Email:______________________________________________________
  19.  
  20. Where did you find FastTimer?_______________________________
  21.  
  22.  
  23. Product(s)              Quantity        Price          Total
  24.  
  25. FastTimer component     ______x        $ 10.00        $_________
  26. FastTimer component
  27.         + source        ______x        $ 15.00        $_________
  28.  
  29. FastTimer site license  ______x        $ 75.00        $_________
  30.  
  31. Shipping ($4.95 U.S., $6.95 outside the U.S.)         $_________
  32.  
  33.                                               TOTAL:  $_________
  34.  
  35.  
  36. Mail this form with your check or money order to:
  37.  
  38.   Eric Nielsen
  39.   RR 1 Box 420
  40.   Alto Pass, IL 62905
  41.  
  42.