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Text File  |  1994-06-30  |  3KB  |  57 lines
  1.                          REGISTRATION/ORDER FORM
  2.  
  3. Send credit card, foreign currency             Send cash or cheque orders
  4. or multiple product orders to:                 in A$ for SKEDEZY only to:
  5.  
  6. ARK ANGLES                                     TOPLINE SOFTWARE
  7. 24 Alexander Ave                               P O Box 66
  8. Hazelbrook  NSW  2779                          Rundle Mall  SA  5000
  9. AUSTRALIA                                      AUSTRALIA
  10. Phone:      (047)588100 or Intl+61-47-588100
  11. Fax:        (047)588638 or Intl+61-47-588638
  12. Internet:   100237.141@compuserve.com
  13. CompuServe: 100237,141
  14.  
  15. From: Name    ___________________________________________________________
  16.  
  17.       Company ___________________________________________________________
  18.  
  19.       Address ___________________________________________________________
  20.  
  21.       Town    ____________________________  State ________  Code ________
  22.  
  23.       Country ___________________________________________________________
  24.  
  25.       Phone   ____________________________  Fax _________________________
  26.  
  27. Where did you obtain or hear about the software? ________________________
  28.  
  29. Computer:      [ ] XT     [ ] AT/286     [ ] 386     [ ] 486     [ ] >486
  30. Memory Size: ____________    Hard Disk Size: __________
  31. Drives:  [ ] 360K 5.25"   [ ] 720K 3.5"   [ ] 1.2M 5.25"   [ ] 1.44M 3.5"
  32. Screen:    [ ] Mono/Herc     [ ] CGA     [ ] EGA     [ ] VGA     [ ] >VGA
  33. Dos Version: _______    Windows Version: _______    OS/2 Version: _______
  34.  ___________________________________________________ _______ ___________
  35. | P R O D U C T  /  L I C E N S E                   | Q T Y | P R I C E |
  36. |___________________________________________________|_______|___________|
  37. |                                                   |       |           |
  38. |___________________________________________________|_______|___________|
  39. |                                                   |       |           |
  40. |___________________________________________________|_______|___________|
  41. |                                                   |       |           |
  42. |___________________________________________________|_______|___________|
  43. |                                                   |       |           |
  44. |___________________________________________________|_______|___________|
  45. | T O T A L                                                 |           |
  46. |___________________________________________________________|___________|
  47.  
  48. [ ] Bankcard    [ ] Mastercard    [ ] Visa    [ ] Cash/Cheque/Draft/Order
  49.  
  50. Credit Card No  _______ _______ _______ _______   Expiry Date ____ / ____
  51.  
  52. Cardholder Name _________________________________________________________
  53.  
  54. Signature       _______________________________   Date __________________
  55.  
  56. Comments:
  57.