=============================================================================== STeve's Atari SALES! 5 West Street Woodland, CA. 95695 =============================================================================== Customer Information: """"""""""""""""""""" NAME :___________________________________________________________ ADDRESS :___________________________________________________________ TOWN/SUBURB:____________________________ STATE:____ POST CODE:________ PHONES :Home (_____)______________ Work (_____)_________________ PHONES :FAX (_____)______________ BBS (_____)_________________ -=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- Billing Information: """""""""""""""""""" Enclosed is: [_] Cash [_] VISA [_] Money Order [_] Check [_] MasterCard [_] Discover (Coming Soon) Credit Credit Card Card Number: [________]-[________]-[________]-[________] Exp. Date: ____/____ SIGNATURE:______________________________________________ Date: ____/____/_____ -=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- Order Information: """""""""""""""""" Qty. Item Description: Price: Total: =============================================================================== | | | ------------------------------------------------------------------------------- | | | ------------------------------------------------------------------------------- | | | ------------------------------------------------------------------------------- | | | ------------------------------------------------------------------------------- | | | ------------------------------------------------------------------------------- | | | ------------------------------------------------------------------------------- | | | ------------------------------------------------------------------------------- | | | ------------------------------------------------------------------------------- | | | ------------------------------------------------------------------------------- | | | ------------------------------------------------------------------------------- (If in California, please add 7.25 Sales Tax) Taxes: ------------------------------------------------------------------------------- (FREE on Software orders over $100.00) Shipping Charges: ------------------------------------------------------------------------------- Total: ------------------------------------------------------------------------------- -=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- Customer Request or Special Instructions: """"""""""""""""""""""""""""""""""""""""" ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- Customers NOTE: Just for our records, not mandatory, we just like to know what our customers have and what they WANT in the future. -=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- Computer Information: """"""""""""""""""""" Please tell us which Atari System(s) you own. Video Game System(s): ---------------------------------------------------------- 8-Bit Computer System(s): ------------------------------------------------------ ST Computer System(s): --------------------------------------------------------- TT030 Computer System(s): ------------------------------------------------------ Falcon 030 Computer System(s): ------------------------------------------------- [End..........] ===============================================================================