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117 lines
3.8 KiB
117 lines
3.8 KiB
<html>
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<head>
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<meta http-equiv="Content-Type"
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content="text/html; charset=iso-8859-1">
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<meta name="GENERATOR" content="Microsoft FrontPage Express 2.0">
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<title>HyperACCESS Order Form</title>
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</head>
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<body bgcolor="#FFFFFF">
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<p align="center"><font color="#0000FF" size="4"
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face="Times New Roman"><b><u>HyperACCESS Order Form</u></b></font></p>
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<p><font face="Times New Roman">Customer Code: HWTD</font></p>
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<p><font color="#0000FF">Print, mail, e-mail, upload, or FAX this
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form to Hilgraeve at the address listed below:</font></p>
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<form method="POST">
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<p>Name: <input type="text" size="45" name="T1"></p>
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<p>Address 1: <input type="text" size="42" name="T2"></p>
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<p>Address 2: <input type="text" size="42" name="T3"></p>
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<p>City: <input type="text" size="46" name="T4"> </p>
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<p>State/Province: <input type="text" size="13" name="T5">
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Postal/Zip Code: <input type="text" size="13" name="T6"></p>
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<p>Country: <input type="text" size="43" name="T7"></p>
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<p>Please fill in the Total column</p>
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<table border="2" cellpadding="5" cellspacing="0" width="600"
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bgcolor="#FFFFFF">
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<tr>
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<td><p align="center">Product</p>
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</td>
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<td><p align="center">List Price</p>
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</td>
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<td><p align="center"><font color="#FF0000"><strong>Act
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Now!</strong></font></p>
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</td>
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<td><p align="center">Total</p>
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</td>
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</tr>
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<tr>
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<td><strong>HyperTerminal Private Edition </strong><br>
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<font size="2">(Commercial single-user license)</font></td>
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<td> </td>
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<td><p align="center">$29.95</p>
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</td>
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<td><input type="text" size="7" name="T8"></td>
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</tr>
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<tr>
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<td><strong>HyperACCESS CD</strong><br>
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<font size="2">(please call for 3.5" disks)</font></td>
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<td><p align="center">$129.00</p>
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</td>
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<td><p align="center">$79.95</p>
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</td>
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<td><input type="text" size="7" name="T9"></td>
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</tr>
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<tr>
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<td>Sales Tax (MI only, add 6%)</td>
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<td> </td>
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<td> </td>
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<td><input type="text" size="7" name="T11"></td>
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</tr>
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<tr>
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<td><font size="3">Shipping </font><br>
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<font size="2">(for US delivery only, call for other
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rates)</font></td>
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<td> </td>
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<td><p align="center">$7.50</p>
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</td>
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<td><input type="text" size="7" name="T12"></td>
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</tr>
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<tr>
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<td>Total</td>
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<td> </td>
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<td> </td>
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<td><input type="text" size="7" name="T13"></td>
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</tr>
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</table>
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<p><br>
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Payment Method: <select name="D1" size="1">
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<option>Check</option>
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<option>Money Order</option>
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<option>Master Card</option>
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<option>VISA</option>
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<option>American Express</option>
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</select></p>
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<p>Credit Card Number: <input type="text" size="34"
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name="T14"> Expiration: <input type="text" size="10"
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name="T15"></p>
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<p>Signature (or name on the card): <input type="text"
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size="46" name="T16"></p>
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</form>
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<p align="center"><font size="1" face="Times New Roman">Limit one
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per customer</font></p>
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<p align="center"><font color="#0000FF" size="5"
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face="Times New Roman">Hilgraeve Inc.<br>
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</font><font color="#0000FF" face="Times New Roman">111 Conant
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Ave.Suite A <br>
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Monroe, MI 48161<br>
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(800) 826-2760 (313) 243-0576<br>
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(313) 243-0645 (FAX)<br>
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[email protected] (e-mail)<br>
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hbbs.hilgraeve.com (BBS upload)</font></p>
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<p> </p>
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<p> </p>
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<p> </p>
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<p> </p>
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</body>
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</html>
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