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1993-08-20
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AutoChek v.2.1 Registration Form
Remit to: From:
Michael L. Torok __________________________________
10101 Highway 9, #5 __________________________________
Ben Lomond, CA 95005 __________________________________
408-336-8625 __________________________________
(8AM-9PM) PST
Contact individual:
__________________________________
__________________________________
Purchase Order Number (if applicable):
__________________________________
Personal Registration
Qty Unit Price Total
___ AutoChek v.2.1 X $5.00 _____
Business Registration
Qty
One computer X $5.00 _____
___ Additional Computers X $1.00 _____
Grand Total _____
California sales tax is included in the above listed prices.
Disk type selection: 5 1/4" ______ 3 1/2" ______
Thank you for your support!