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Text File  |  1995-12-07  |  5KB  |  103 lines
  1.  
  2.  REGISTRATION                                                            
  3.  ------------                                                             
  4.                                                                           
  5.  CyberCom v1.50                                                            
  6.  Copyright (C) 1995, Megalomania Software                                  
  7.  
  8.  
  9.  Registration in the UK/Eire
  10.  ---------------------------
  11.  
  12.  Dave Carter
  13.  CyberCom Registrations
  14.  PO Box 50
  15.  Glossop
  16.  Derbyshire
  17.  SK13 9QS
  18.  England
  19.  
  20.  E-Mail     : davec@zetnet.co.uk
  21.  Compuserve : 101332,205
  22.  WWW        : http://ourworld.compuserve.com/homepages/davec
  23.  BBS/Data   : +44 (0)181-402 3350 (28 lines)
  24.  Fax        : +44 (0)181-289 7761
  25.  Voice      : +44 (0)585-134567 (6pm - 11pm GMT)
  26.  
  27.  FidoNet    : 2:25/60        RA-Net   : 73:7441/60   WorldNet : 64:777/0
  28.  MercuryNet : 240:102/1      VIR-Net  : 9:441/204    AmigaNet : 39:133/34
  29.  PascalNet  : 115:4401/411   OS/2-Net : 81:444/55    MusicNet : 808:501/180
  30.  
  31.  HOW TO REGISTER:
  32.  
  33.  - Please complete this form in full.
  34.  
  35.  - Print the form, and send it with cheque or funds enclosed, or e-mail /
  36.    post / netmail / fax it, if registering by credit card.
  37.  
  38.  - When your registration has been received and verified you will be sent
  39.    a registration code which will enable all registered features and allow
  40.    you to continue using CyberCom for as long as you wish.
  41.  
  42.  
  43.   CYBERCOM v1.50 - REGISTRATION FORM:
  44.  
  45.   PERSONAL INFORMATION:
  46.                                                                              
  47.   Company Name______________________________________ (Leave Blank if None)   
  48.                                                                              
  49.   BBS Name__________________________________________ (Leave Blank if None)   
  50.                                                                              
  51.   Contact_________________________________________________________________   
  52.             (Use your real name: FIRST LAST, i.e. JOE USER)        
  53.                                                                              
  54.   Title________________________________ and/or [_] System Operator (SysOp)   
  55.                                                                              
  56.   Voice Phone (____)____-_____                 Data Phone (____)____-_____   
  57.     Fax Phone (____)____-_____               Data Phone 2 (____)____-_____   
  58.                                                                              
  59.   Address: _______________________________________________________________
  60.                                                                              
  61.            _______________________________________________________________
  62.                                                                              
  63.   City/Town_______________________ County ________________________________
  64.                                                                              
  65.   Postal Code_________ Country: __________________________________________   
  66.                                                                              
  67.   Internet EMAIL Address: ________________________________________________   
  68.                                                                              
  69.                                                                              
  70.  
  71.   PAYMENT INFORMATION:
  72.  
  73.                         Select Form of Payment
  74.  
  75.     [_] Cheque Enclosed       [_] Cash          [_] Money Order Enclosed
  76.     [_] American Express      [_] Diners Club   [_] Access
  77.     [_] Visa Card             [_] Barclaycard   [_] Mastercharge
  78.  
  79.     Card No: [____] [____] [____] [____]     Expiry date: [__/__] (MM/YY)
  80.  
  81.     NB: Please add 5% bank charge if paying by credit card.
  82.  
  83.   No. of Copies    Pricing/Copy                                              
  84.        1             £35.00
  85.      2 - 9            31.50     ORDER:
  86.     10 - 24           29.75
  87.     25 - 49           28.50     No of Copies: _____ @ £_____ =  £______
  88.     50 - 99           27.50          Credit card charge @ 5% =  £______
  89.    100 - 149          26.00                   Total Enclosed =  £______
  90.    150 - 199          24.50
  91.                                                                             
  92.                                                                              
  93.   Signature (If form sent by mail/fax)_________________________________
  94.  
  95.   Full name and address of credit card holder, if different from above:
  96.  
  97.   ____________________________________________________________________
  98.  
  99.   ____________________________________________________________________
  100.  
  101.   ____________________________________________________________________
  102.  
  103.