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  1.                 Pentomino Order Form
  2.                 ====================
  3.  
  4.        Name: __________________________________________________
  5.  
  6.     Company: __________________________________________________
  7.  
  8.     Address: __________________________________________________
  9.  
  10.        City: ___________________________ State: _______________
  11.  
  12.     Country: _______________________ Post/Zip Code: ___________
  13.  
  14.  
  15. Your Email Address: ___________________________________________
  16.  
  17. Where did you obtain
  18.     the program from:  ________________________________________
  19.  
  20. Payment:
  21. =======
  22. All amounts are in Australian Dollars. The exchange rate is
  23. approximately US$0.75 for each AU$1.00 (ie. AU$20 is about US$15)
  24.  
  25. PAYMENTS MUST BE IN AUSTRALIAN DOLLARS PAYABLE AT AN AUSTRALIAN BANK.
  26. (Cash is discouraged due to lack of security, but is acceptable)
  27.  
  28.    Pentomino program:                   ____ copies  = $_______
  29.      1       license   no discount. ($20.00)
  30.      2 - 5   licenses 20% discount. ($16.00 each copy)
  31.      6 - 20  licenses 35% discount. ($13.00 each copy)
  32.      21 +    licenses 50% discount. ($10.00 each copy)
  33.  
  34.    If you wish to receive the source code (see "Registering"
  35.    in Help) then add one of the following shipping options:
  36.       Internet Email   ............  No Charge
  37.       Within Australia ............  $5.00
  38.       Overseas         ............  $7.00             $_______
  39.  
  40.                                                 Total  $_______
  41.  
  42. If you are receiving the source code through the
  43. post then specify your disk size:
  44.                                  ____ 5.25" ____ 3.5"
  45.  
  46. Payments:
  47. ========
  48. Make your payment made out to Stephen Balogh, and send it to:
  49.  
  50.      PO Box 414
  51.      Caulfield East
  52.      Melbourne
  53.      AUSTRALIA     3145
  54.  
  55. Comments:
  56. ========
  57.  
  58. ___________________________________________________________________
  59.  
  60. ___________________________________________________________________
  61.  
  62. ___________________________________________________________________
  63.  
  64. ___________________________________________________________________
  65. If you have access to the Internet then I can be contacted at:
  66.    steve@monu6.cc.monash.edu.au  or  steve@monash.edu.au
  67.