home *** CD-ROM | disk | FTP | other *** search
/ DP Tool Club 15 / CD_ASCQ_15_070894.iso / vrac / slbaud.zip / REGISTER.FRM < prev    next >
Text File  |  1994-06-12  |  1KB  |  34 lines

  1.  
  2.  
  3.  
  4.                       SLBAUD v1.0 Registration Order Form
  5.  
  6.      Qty       Item                                     US      Price
  7.  
  8.      ___  Registration and Disk (within U.S.)....... @ $10 ea $________
  9.  
  10.           Ohio residents add State Sales Tax ...........      $________
  11.  
  12.                                                      Subtotal $________
  13.  
  14.                                                         TOTAL $________
  15.  
  16.      Remit To:          Tom Huff
  17.                         17515 Libby Rd.
  18.                         Maple Heights, Ohio, 44137 USA
  19.  
  20.  
  21.      Desired Media Size (check one) 
  22.  
  23.       5.25" (360k) ____    3.5" (720k) ____   3.5" (1.4m) ____
  24.  
  25.      Your BBS Name ____________________________________________________
  26.  
  27.      Your BBS Number (optional) _______________________________________
  28.  
  29.      Comments/Suggestions _____________________________________________
  30.  
  31.      Mailing Address __________________________________________________
  32.                      __________________________________________________
  33.                      __________________________________________________
  34.