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Text File  |  1992-04-15  |  1.8 KB  |  63 lines
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  7.           ORDER ENTRY FORM
  8.           ____________________________________________________________
  9.  
  10.  
  11.           To order the most current version of Pony Express just
  12.           complete the form below and enclose the proper payment.
  13.           You can also order by telephone by calling (913)642-5005.  
  14.           Our FAX number is (913)642-5005-6.
  15.  
  16.  
  17.           Contact Name:_______________________________________________
  18.  
  19.           Title:________________________________
  20.  
  21.           Company Name:_______________________________________________
  22.  
  23.           Street Address:_____________________________________________
  24.  
  25.           City:_________________________ St:______ Zip:_______________
  26.  
  27.           Telephone:____________________ Alternate:___________________
  28.  
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  30.           Quantity
  31.  
  32.           ________ Pony Express software with      @ $50.00 ea _______
  33.                  user's guide, product update notification and
  34.                  voice tech. support (includes shipping)
  35.  
  36.           ________ Pony Express software with      @$150.00 ea _______
  37.                  scale interface support and
  38.                  interface cable. (includes shipping)
  39.  
  40.                  Diskette Format: [  ] 3.5"     [  ] 5.25"
  41.  
  42.                Kansas residents add 5.85% sales tax            _______
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  45.                                     Total        _________
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  47.           Method of Payment: [  ] Check with Order    [  ] Money Order
  48.                        [  ] Mastercard          [  ] Visa
  49.  
  50.           Card #:__________________________________ Exp. Date:___ /___
  51.  
  52.           Signature:______________________________________
  53.  
  54.           Cardholder's Name:______________________________
  55.  
  56.                Remit To: Melisco Marketing, Inc.
  57.                          9719 Ensley Lane
  58.                          Leawood, KS  66206-2246
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