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Text File  |  1993-12-16  |  2KB  |  50 lines
  1. Registration Form
  2.  
  3. EMAIL ADDRESS:___________________________________________
  4.  
  5. NAME:____________________________________________________
  6. ADDRESS:_________________________________________________
  7.     _________________________________________________
  8.     _________________________________________________
  9. CITY:________________________ STATE:____ ZIP:____________
  10. COUNTRY:____________
  11.  
  12. PHONE # (Data):  ___ ____ ______________
  13.     (Voice): ___ ____ ______________
  14.  
  15. General info:
  16.  
  17. Type of Data Acquisition System(s):
  18.                     _________________________________________________
  19.             _________________________________________________
  20.             _________________________________________________
  21.             _________________________________________________
  22.             _________________________________________________
  23.  
  24. Machine type:  8088/6[_]  80286[_]  80386[_]  80486[_]  Other[_] 
  25. Machine name: ________________________________________
  26.  
  27. Display type:  MDA[_]  CGA[_]  Herc[_]  EGA[_]  MCGA[_]  VGA[_]  SVGA[_]
  28. Card name:_____________________________________________
  29.  
  30. Floppy drives:    3½ 720k[_]  3½ 1.44M[_]  3½ 2.88M[_]
  31.           5¼ 360k[_]  5¼ 1.2M [_]
  32.  
  33. Other configuration:_________________________________________________
  34.             _________________________________________________
  35.             _________________________________________________
  36.             _________________________________________________
  37.             _________________________________________________
  38.  
  39.                 Tack         ____       @ $35
  40.                 Patchit      ____       @ $35
  41.  
  42. please send checks/money to:
  43.     George Grant
  44.     38 Banks St. #2
  45.     Somerville, MA  02144
  46.     (617) 625-2419 voice
  47.  
  48. I can accept US currency in cash, checks or money orders.  Sorry, I can't
  49. accept credit cards.
  50.