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Text File  |  1998-06-13  |  1KB  |  50 lines
  1. To:  PsL, Inc.
  2. Online order http://www.arclab.com/products/1stnote/order
  3. EMail order: 30398@pslweb.com
  4. Fax: (USA) 713-524-6398 
  5.  
  6. Credit card fax order for Item #30398
  7. Packager MK1 by arclab software GdbR
  8.  
  9. We accept MC, Visa, Amex, Discover
  10.  
  11. ______ 1 computer    @ $20     
  12. ______ 2-15 computer    @ $15
  13.  
  14. Shipping and Handling: 
  15. (  ) No shipping - email it. (no disk will be sent)
  16. (  ) send via mail $5
  17.  
  18. (Please do not use any umlauts or characters with accents or 
  19. diacritical marks.)
  20.  
  21. First/Middle Name:__________________________________________
  22.  
  23. Last Name: _________________________________________________
  24.  
  25. Company name: ______________________________________________
  26.   
  27. Address:____________________________________________________
  28.  
  29. City: ______________________________________________________
  30.  
  31. State/Province: _______________________ (U.S. & Canada only)
  32.  
  33. Zip, Country: ______________________________________________
  34.  
  35. Phone # ____________________________________________ (voice)
  36.  
  37. Your email address: ________________________________________
  38.  
  39. BANK name and phone number:_________________________________
  40.  
  41. Credit card number: ________________________________________
  42.  
  43. Expiration: ________________________________________________
  44.  
  45.  
  46.  
  47. Date: ____________  Signature:______________________________
  48.  
  49. PsL is a credit card order service, not the publisher!
  50. Author: arclab GdbR office@arclab.com, FAX: +49941990065