home *** CD-ROM | disk | FTP | other *** search
/ PC/CD Gamer UK 30 / PCGAMER30.bin / dos / hubie / order.frm < prev    next >
Encoding:
Text File  |  1996-01-07  |  2.1 KB  |  63 lines
  1. Serendipity Software
  2. 2828 Kennedy Blvd., Box 269
  3. Jersey City, NJ 07306
  4.  
  5. NOTE: This form is for ordering via checks and money orders only.
  6.  
  7.         * To find out how to order via Credit Card, or CompuServe,
  8.                run HUBIE and, from the main menu, choose the
  9.                    "* HOW TO REGISTER HUBIE *" option.
  10.  
  11.                         Customer Information
  12.  
  13. Name           : __________________________________________________________
  14.  
  15.  
  16. Company        : __________________________________________________________
  17.  
  18.  
  19. Address        : __________________________________________________________
  20.  
  21.                  __________________________________________________________
  22.  
  23.                  __________________________________________________________
  24.  
  25.  
  26. City           : __________________________________________________________
  27.  
  28. State/Province : __________________________________________________________
  29.  
  30. ZIP/Postal Code: __________________________________________________________
  31.  
  32. Country        : __________________________________________________________
  33.  
  34. Date           : __________________________________________________________
  35.  
  36. Phone #        : __________________________________________________________
  37.  
  38. Fax #          : __________________________________________________________
  39.  
  40. Notes          : __________________________________________________________
  41.  
  42.                  __________________________________________________________
  43.  
  44.                  __________________________________________________________
  45.  
  46. Hubie - Registered Edition                                       $24.95
  47.  
  48. Shipping & Handling within US & Canada $4.00 per 1.44Mb Disk
  49. Outside US & Canada $6.00 per 1.44Mb Disk                        ________
  50.  
  51.  
  52. Quantity                                                         ________
  53.  
  54.  
  55. TOTAL ENCLOSED US FUNDS                                       US$________
  56.  
  57. TERMS:
  58.   Check or Money Order must be drawn on a US bank in US funds.
  59.   Please make all payments payable to Serendipity Software.
  60.   Prices and terms are subject to change without notice.
  61.  
  62.  
  63.