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Text File  |  1991-10-15  |  2.6 KB  |  78 lines
  1.  
  2.                      LET YOUR PRINTER DO ALL THE WORK!!!
  3.  
  4.          -------------------  INSTANT MAILER  ----------------------
  5.  
  6.                         Professional-YAM Order Form
  7.  
  8.  
  9.  
  10. Remit To:           Omen Technology INC             FAX: 503-621-3735
  11.                     POB 4681
  12.                     Portland OR  97208-4681
  13.  
  14.  
  15.  
  16.      Professional-YAM DOS Software and Binder          $139.00    ______
  17.        (Single Machine License)
  18.  
  19.      3.5 inch disk instead of 5.25 inch                       ( )
  20.  
  21.      UPS BLUE (second day air)                          $ 5.00    ______
  22.  
  23.      International Air Mail ($20 for Australia, etc.)   $15.00    ______
  24.  
  25.                                              + $5.00 Shipping and Handling
  26.                                                for C.O.D. or credit card
  27.  
  28.                                                         Total     ______
  29.  
  30. Payment by:  Check (U.S. bank or branch) enclosed ( )    MC ( )     VISA ( )
  31.  
  32. Use Address on check ( )
  33.  
  34. Name     ___________________________________________________________________
  35.  
  36. Address  ___________________________________________________________________
  37.  
  38.           __________________________________________________________________
  39.  
  40.           __________________________________________________________________
  41.  
  42.           __________________________________________________________________
  43.  
  44.  
  45.                  ..... Following only needed for Credit Card .....
  46.  
  47. Work Phone  (____) __________________  Home Phone   (____)  ________________
  48.  
  49. Card #  _____________________________________________  Expires _____________
  50.  
  51. Cardholder name  ___________________________________________________________
  52.  
  53. Signature __________________________________________________________________
  54.  
  55.  
  56. Omen Technology Inc Federal TAX ID #: 930858776   Oregon #: 536565
  57.          -------------------  INSTANT MAILER  ----------------------
  58.  
  59. Fold at the page break below with the printing facing out.  Then fold
  60. letter style, exposing the mailing address and hiding your information.
  61. If necessary, staple check to the mailer, then staple or tape sides and top.
  62.  
  63. _________________________________                                     Place
  64.  
  65. _________________________________                                     Stamp
  66.  
  67. _________________________________                                     Here
  68.  
  69.  
  70.  
  71.  
  72.  
  73.                                          Omen Technology INC
  74.                                          Post Office Box 4681
  75.                                          Portland OR  97208-4681  U.S.A.
  76.  
  77. YAMDEMO Oct-15-91
  78.