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Text File  |  2000-02-25  |  2.2 KB  |  54 lines
  1. -----Gepeto Software Order Form-----
  2. Please print this form, fill it out,
  3. and mail it with your payment to complete your order.
  4.  
  5. **Make Checks or Money Orders Payable to:  Joe Tompkins
  6.  
  7. Send this completed form with payment to:
  8. Joe Tompkins
  9. 130 Wintergreen Ct
  10. Covington, GA 30016
  11.  
  12.  
  13. Your Name_____________________________________
  14.  
  15. -or-
  16.  
  17. School Name___________________________________
  18.  
  19. Email Address 
  20. (to receive registration code via Email-- Allow 1 week for reply):
  21.  
  22. _____________________________________ 
  23.  
  24. Mailing Address 
  25. (to receive registration code via postal mail-- allow 5 weeks for reply)
  26. -United States Addresses ONLY-- All others will receive code via email-
  27.  
  28. Street:_________________________________________________________
  29.  
  30. City______________________State_________ Zip____________________
  31.  
  32. Please indicate the product(s) you wish to register below:
  33. ______________________________________________________________________
  34. Product:            |   #    |   Unit Price   |   Total   |
  35. ----------------------------------------------------------------------
  36. Activity Maker (Single User)    |    |   $10.00 (US)     |         |
  37. ----------------------------------------------------------------------
  38. Activity Maker (Site License)    |    |   $50.00 (US)     |         |
  39. ----------------------------------------------------------------------
  40. Vocab-Flash (Single User)    |    |   $10.00 (US)  |         |
  41. ----------------------------------------------------------------------
  42. Vocab-Flash (Site License)    |    |   $50.00 (US)     |         |
  43. ----------------------------------------------------------------------
  44. StoryMaker (Single User)    |    |   $10.00 (US)     |         |
  45. ----------------------------------------------------------------------
  46. StoryMaker (Site License)    |    |   $50.00 (US)     |         |
  47. ----------------------------------------------------------------------
  48. Kid Cards (Single User)        |    |   $10.00 (US)     |         |
  49. ----------------------------------------------------------------------
  50. Kid Cards (Site License)    |    |   $50.00 (US)     |         |
  51. ----------------------------------------------------------------------
  52. Homework Collector(Site License)|    |   $30.00 (US)     |         |
  53. ----------------------------------------------------------------------
  54.                     Total Enclosed: