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Text File  |  1995-11-14  |  4KB  |  77 lines
  1.  
  2.  REGISTRATION                                                            
  3.  ------------                                                             
  4.                                                                           
  5.  CyberCom v1.50                                                            
  6.  Copyright (C) 1995, Megalomania Software                                  
  7.  
  8.  
  9.  (All Other Registrations)                 
  10.  
  11.  Megalomania Software                      
  12.  779 Cathcart Blvd                         
  13.  Sarnia, Ontario CANADA                    
  14.  N7V 2N6                                   
  15.  BBS: 519-332-0638  28.8k vFC              
  16.  EMAIL: jperciva@megalomania.com
  17.  
  18.  
  19.  HOW TO REGISTER:
  20.  
  21.  - Please complete this form in its entirety from top to bottom. German and
  22.    Europe users please check seperate registration form. (REGFORM.GER, and
  23.    REGFORM.EUR respectively).
  24.  
  25.  - Print this form and send it to MEGALOMANIA SOFTWARE with cheque or funds
  26.    enclosed.
  27.  
  28.  - When your registration has been received and verified you will be sent
  29.    a registration code which will enable all registered features and allow
  30.    you to continue using CyberCom for as long as you wish.
  31.  
  32.  
  33.   CYBERCOM v1.50 - REGISTRATION FORM:
  34.  
  35.   PERSONAL INFORMATION:
  36.                                                                              
  37.   Company Name______________________________________ (Leave Blank if None)   
  38.                                                                              
  39.   BBS Name__________________________________________ (Leave Blank if None)   
  40.                                                                              
  41.   Contact_________________________________________________________________   
  42.             (Use your real name: FIRST LAST, i.e. JOE USER)        
  43.                                                                              
  44.   Title________________________________ and/or [_] System Operator (SysOp)   
  45.                                                                              
  46.   Voice Phone (____)____-_____                 Data Phone (____)____-_____   
  47.     Fax Phone (____)____-_____               Data Phone 2 (____)____-_____   
  48.                                                                              
  49.   Street__________________________________________________________________   
  50.                                                                              
  51.   Suite/PO Box/Apt/Rt/Ms__________________________________________________   
  52.                                                                              
  53.   City____________________________ Stat/Province__________________________   
  54.                                                                              
  55.   Postal Code_________ Country: __________________________________________   
  56.                                                                              
  57.   Internet EMAIL Address: ________________________________________________   
  58.                                                                              
  59.                                                                              
  60.  
  61.   PAYMENT INFORMATION:
  62.  
  63.                         Select Form of Payment                                                                                                           
  64.     [_] Cheque Enclosed       [_] Cash       [_] Money Order Enclosed
  65.                                                                              
  66.   No. of Copies    Pricing/Copy                                              
  67.        1             $45.00                                                  
  68.      2 - 9            40.00     ORDER:                                       
  69.     10 - 24           38.00                                                  
  70.     25 - 49           36.00     No of Copies: _____ @ $_____ =  $______      
  71.     50 - 99           35.00                                                  
  72.    100 - 149          33.00                   Total Enclosed =  $______      
  73.    150 - 199          31.00                                                  
  74.                                                                             
  75.                                                                              
  76.   Signature (If this form is sent by mail)_________________________________
  77.