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Text File  |  1992-06-15  |  1.4 KB  |  41 lines
  1.  
  2.                             WINJPEG ORDER FORM
  3.  
  4.     Name    ___________________________________________________________
  5.  
  6.     Address ___________________________________________________________
  7.  
  8.     City    __________________________ State _________ ZIP ____________
  9.  
  10.     Country (if outside US) ___________________________________________
  11.  
  12.     Phone Number (optional) __________________  Circle:  home  or  work
  13.  
  14.     Email Address (optional) __________________________________________
  15.  
  16.     Circle Type of Email Address:  Internet  or  Compuserve
  17.  
  18.     Choose Disk Size (check one):  __  4  5 1/4" DS/DD (360K) disks
  19.                                    __  2  3 1/2" DS/DD (720K) disks
  20.                                    __  1  3 1/2" DS/HD (1.44 Mb) disk
  21.  
  22.     Shipping (check one):  __  E-mail (no additional charge)
  23.                            __  US residents (add $3)
  24.                            __  Non-US residents (add $10)
  25.  
  26.  
  27.       
  28.               Registration Fee                          $15.00
  29.               5% Sales Tax (MA residents only)        + ______
  30.               Shipping                                + ______
  31.  
  32.               Total Enclosed                            ______
  33.  
  34.  
  35.  
  36.  Mail to:  Norman Yee             Internet Address: nyee@osiris.ee.tufts.edu
  37.            58 Chandler St.
  38.            Boston, MA 02116
  39.  
  40.                      *** Thank you for your order! ***
  41.