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Text File  |  1993-05-22  |  2KB  |  52 lines
  1.  
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  5.                            REGISTRATION FORM/INVOICE
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  10.       Remit To:                                Ship To:
  11.  
  12.       Infinity Data Products                   ____________________________
  13.       1404 Old Cape Road, Suite 203            ____________________________
  14.       P.O. Box 533                             ____________________________
  15.       Jackson, MO 63755                        ____________________________
  16.                                                ____________________________
  17.           
  18.                                                Contact Individual/Phone:
  19.       How did you get your copy of
  20.       MEMBER?                                  ____________________________
  21.                                                
  22.       ____________________________             ____________________________
  23.  
  24.   ___________________________________________________________________________
  25.    Quantity    Description                  Unit Price     Total
  26.   ---------------------------------------------------------------------------
  27.                                MEMBER Version 4.0
  28.  
  29.     _____      Single User Registration        $ 50.00    ___________
  30.  
  31.                    Missouri Residents Sales Tax @ 6.225%  ___________
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  33.                                                 Shipping     3.00
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  35.                                                TOTAL DUE  ____________
  36.  
  37.       Check One:  _____ 5 1/4" Disks
  38.        
  39.                   _____ 3 1/2" Disks
  40.  
  41.       For Credit Card Orders:
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  44.              _____ Master Card    _____ Visa
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  46.              Card #___________________________________
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  48.              Expiration Date ___/___
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  51.              Signature_______________________________________
  52. .