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Text File  |  1996-10-05  |  1.6 KB  |  43 lines
  1.                  ORCHIS REGISTRATION FORM AND INVOICE
  2.  
  3.                          Price          Quantity       Total
  4.  
  5. ORCHIS                   $29            __________     _______________
  6.  
  7. Massachusetts Residents add 5%                   _______________
  8.  
  9. Outside the USA add $5 shipping                        _______________
  10.  
  11.                                                Total:  _______________
  12.  
  13. Name:  _______________________________________________________________
  14.  
  15. Address:  ____________________________________________________________
  16.  
  17. City:  ______________________________________  State:  _______________
  18.  
  19. Country:  ___________________________________  ZIP:  _________________
  20.  
  21. Telephone:  (___________) - __________________________________________
  22.  
  23. [  ] Payment enclosed    Prefered diskette format:  [  ] 3 1/2 (1.44M)
  24. [  ] Mastercard                                     [  ] 3 1/2 (720Kb)
  25. [  ] VISA                                           [  ] 5 1/4 (360Kb)
  26.  
  27. Card number:  _______________________________  Expiration:  __________
  28.  
  29. Signature:  __________________________________________________________
  30.  
  31. From what vendor did you obtain your shareware copy of ORCHIS:
  32.  
  33. ______________________________________________________________________
  34.  
  35. Please note:  Make checks payable to TRIONUM Inc.
  36.               The prices given above are in US dollars.
  37.               After 98DEC31 call for prices:  1-800-TRIONUM.
  38.               A signature is required for credit card payment.
  39.  
  40. Remit to:                     TRIONUM Inc.
  41.                         PO Box 305, Kendall Sq.
  42. ORCHIS v1.2 [CI]        Cambridge, MA USA 02142
  43.