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Text File  |  1992-09-01  |  1.7 KB  |  51 lines
  1.                              ORDER FORM
  2.  
  3. NAME:       ____________________________________________________
  4.  
  5. ADDRESS:    ________________________ CITY/TOWN: ________________
  6.  
  7. STATE/PROV: __________ ZIP/CODE: _________ COUNTRY: ____________
  8.  
  9. TELEPHONE:  ______________________ 5.25 (360K) __ 3.50 (720K) __
  10.  
  11. MC ___ VISA___ NUMBER __________________________ Expires ___/___
  12.  
  13. SIGNATURE: ____________________________ DATE: _____/_____/______
  14.  
  15. QTY           DESCRIPTION                          PRICE   TOTAL
  16. ___ _____________________________________________  _____   _____
  17.  
  18. ___ The Only Way To Win At Lotto book             $39.95  ______
  19.  
  20. ___ Introduction To Systems and Strategies book   $ 3.95  ______
  21.  
  22. ___ For Advanced Players book                     $ 4.95  ______
  23.  
  24. ___ For Experts book                              $ 9.95  ______
  25.  
  26. ___ Lotto Planner Plus book                       $ 4.95  ______
  27.  
  28. ___ Pick-5 Lotto book                             $ 4.95  ______
  29.  
  30. ___ Lottery Winning Strategies cassette tape      $14.95  ______
  31.  
  32. ___ Lotto Challenger       (BASIC $29.50 or GRAND $39.50) ______
  33.  
  34.     Lotto Challenger Data File (one Free): ____________
  35.  
  36. ___ The Daily Number Buster program               $49.95  ______
  37.  
  38.                                                Subtotal:  ______
  39.  
  40.    Less 10 percent (Discount for registered users only): -______
  41.  
  42.          S&H $3.50 US (1st class), $8.50 overseas (air):  ______
  43.  
  44.                      Florida residents add 6% sales tax:  ______
  45.  
  46.                                                   TOTAL:  ______
  47.  
  48. Data Solutions, 1529 Thistledown Drive, Brandon, FL 33510,U.S.A.
  49. CompuServe: 72356,354    Telephone: 800-783-8934 or 813-653-3093
  50. 
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