************************************************************************** * * * Professional Carrier - v1.24 * * Copyright 1995,96 by BlueCollar Software * * * * Published exclusively by: * * RMH Computer Services * * PO Box 657 * * Beech Grove IN 46107-0657 * * (317) 782-9903 * * * ************************************************************************** ORDER FORM -------------------------------------------------------------------------- Send registration RMH Computer Services [ you can call ] form and payment to: PO BOX 657 [ 317-782-9903 ] BEECH GROVE, IN 46107-0657 [ to order via ] USA [ VISA/MasterCard ] -------------------------------------------------------------------------- I have enclosed (US Funds) for the following product: [ ] Professional Carrier - $59.00 ................... $_____ Indiana residents must add 5% State sales tax ................. $_____ Shipping/Handling ............................................. $_____ [ ] USA residents please add .............. $3.00 S/H [ ] Canada/Mexico residents please add .... $5.00 S/H [ ] Other residents please add ............ $8.00 S/H Total .................. $_____ PLEASE TYPE OR PRINT (all information will remain confidential) Name...: __________________________________________________________ Address: __________________________________________________________ : __________________________________________________________ : __________________________________________________________ Phone Number (Required)..: ___________________ Sales Code: PC124ADN Do you have a CompuServe Acct? [y/n]: ____ If yes, ID# _______________ I would like to receive: [___] 3-1/2" disks (720k) *[___] 5-1/4" disks (360k) (* NOTE: There is an additional $5.00 charge for 5-1/4" disks) CREDIT CARD ORDERS ------------------ For fast Credit Card (MC/VISA) ordering, please call us at 317-782-9903. Or, you can provide the information (including your signature!) in the space below. *ALL* spaced must be completed: +------------------------------------------------------------------+ | We can accept MasterCard or Visa credit card payments. Fill out | | the following ONLY if you are making payment by MC or Visa. | | | | MasterCard [_] Visa [_] Number [____ ____ ____ ____] | | | | Name on the Card [_____________________________________________] | | | | Expires [_______] Signature (*)________________________________ | +------------------------------------------------------------------+ (*) NOTE: This *REQUIRES* a hand-written signature!