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Text File  |  1997-02-15  |  1.8 KB  |  55 lines
  1. ORDER FORM for MADRAC v1.2
  2.  
  3. Price:               US $9: disquette via regular mail
  4.                      US $7: by E-mail
  5.  In canadians funds, please add $1 (for a total of CDN $10 and CDN $8)
  6.  
  7.  If you live in Canada or United States, you can send a check.
  8.  In all other countries, you must send a money order
  9.  
  10.              Marc-Andre Dumas
  11.              122 d'Auvergne
  12.              Gatineau, Quebec
  13.              J8T 1J3  CANADA
  14.  
  15.  
  16.               I want MADRAC: [  ] via mail
  17.                              [  ] via E-Mail
  18.  
  19.     Check or money order in: [  ] canadians funds
  20.                              [  ] americans funds
  21.  
  22.                     Version: [  ] english
  23.                              [  ] french
  24.  
  25.  
  26. First name and last name: ___________________________________________________
  27.  
  28. Adresse: ____________________________________________________________________
  29.  
  30. _____________________________________________________________________________
  31.  
  32. Postal code/ZIP: ________________  City: ____________________________________
  33.  
  34. State/province and country: _________________________________________________
  35.  
  36. E-mail adresse: _____________________________________________________________
  37.  
  38.  
  39.  
  40.  
  41. Where did you found MADRAC: _________________________________________________
  42.  
  43. _____________________________________________________________________________
  44.  
  45. Comments, suggestions, bug, etc...: _________________________________________
  46.                                                              
  47. _____________________________________________________________________________
  48.  
  49. _____________________________________________________________________________
  50.  
  51. _____________________________________________________________________________
  52.  
  53. Date: _______________________
  54.  
  55.