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Text File  |  1994-06-05  |  2.5 KB  |  63 lines
  1.   --------------------------------------------------------------------------
  2.                    ORDER FORM
  3.   --------------------------------------------------------------------------
  4.  
  5.  
  6.    Qty   Description                    Price   Total
  7.   +----+-------------------------------+-------+-----+  SHIPPING & HANDLING
  8.   |    |  Tangram                      | $12.00|     |  The shipping charge 
  9.   +----+-------------------------------+-------+-----+  is $3 world-wide.
  10.   |    |  Minefield For Everybody      |  $5.00|     |                     
  11.   +----+-------------------------------+-------+-----+  NOTE: Orders from              
  12.   |    |                               |       |     |  within ISRAEL that
  13.   +----+-------------------------------+-------+-----+  are paid in Sheqels
  14.   |    |                               |       |     |  must add 17% V.A.T.
  15.   +----+-------------------------------+-------+-----+
  16.              SHIPPING/HANDLING    $3   |  3  |   
  17.                            +-----+   
  18.                   TOTAL        |     |
  19.                            +-----+
  20.   When paying in non-US currency, please show currency and exchange rate
  21.  
  22.   Currency_________________ Exchange Rate ______ to  $1 US 
  23.  
  24.   Make checks payable to: Judah Warshaw         
  25.   In ISRAEL make checks payable to THE SOFTWARE HOUSE
  26.  
  27.   Disk Size:  ___ 5.25"  ___ 3.5"  (Will use 5.25" if not indicated)
  28.   
  29.   Payment:  _____ Check ____ Money Order   ______ MasterCard ____ Isracard
  30.   
  31.   Card Number:  _______ _______ _______ _______  Expiration Date:  ________
  32.        (NOTE: Minimum Credit Card Order $15.00)
  33.   
  34.   Signature:  _________________________ (credit card orders must be signed)
  35.   
  36.   Name:  __________________________________________________________________
  37.   
  38.   Address:  _______________________________________________________________
  39.   
  40.   City/State/Zip:  ________________________________________________________
  41.  
  42.   Country _________________________________________________________________
  43.   
  44.          Send to:   Judah Warshaw
  45.                 P.O. Box 27054
  46.                 Jerusalem   91270
  47.                 ISRAEL
  48.  
  49.  
  50.   Where did you get your shareware copy of Tangram?
  51.   
  52.   Catalog Vendor _____________________________________________________
  53.   
  54.   BBS ________________________________________________________________
  55.   
  56.   On-Line Service ____________________________________________________
  57.   
  58.   Friend _____________________________________________________________
  59.   
  60.   Other ______________________________________________________________
  61.   
  62.   ---------------------------------------------------------------aspcd------
  63.