home *** CD-ROM | disk | FTP | other *** search
/ Programmer 7500 / MAX_PROGRAMMERS.iso / PROGRAMS / UTILS / MOUSE / AMPLIF4.ZIP / ORDER.FRM < prev   
Encoding:
Text File  |  1991-01-17  |  1.4 KB  |  39 lines

  1. Reccomm order form - print, fill out, and send check or money order to:
  2.                                 
  3.                                 Reccomm Electronics
  4.                                 C.O. Brian Dietz
  5.                                 190 Hemenway Rd.
  6.                                 Framingham, MA 01701
  7.  
  8.  
  9.  
  10.        Item                       Quantity     Price
  11. Excalibur 16 Watt Amp($10.00)        ( )      _______ 
  12.  
  13. Excalibur Delux Set($35.00)          ( )      _______
  14.    16 Watt amp, 4 sound disks,
  15.    and 16 Watt 8 Ohms speaker.
  16.  
  17. Sound Disk One($2.00)                ( )      _______
  18.  
  19. Sound Disk Two($2.00)                ( )      _______
  20.  
  21. Sound Disk Three($2.00)              ( )      _______
  22.  
  23. Sound Disk Four($2.00)               ( )      _______
  24.  
  25. Shipping & Handling($4.00)                    $4.00
  26.                           Total      ( )      _______
  27.  
  28. Disk Choice _________________________________________
  29.  
  30. Comments    _________________________________________
  31. _____________________________________________________
  32. _____________________________________________________
  33. _____________________________________________________
  34. Address(please print)
  35. _____________________________________________________
  36. _____________________________________________________
  37. _____________________________________________________
  38. _____________________________________________________
  39. Telephone (   )   -