home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
DP Tool Club 17
/
CD_ASCQ_17_101194.iso
/
vrac_os2
/
padhd11.zip
/
ORDERFRM.DOC
< prev
next >
Wrap
Text File
|
1994-09-10
|
2KB
|
53 lines
------------------------------------------------------------------
REGISTRATION FORM
PADHD ver. 1.1
Copyright (c) 1994 by Gary L. Robinson
------------------------------------------------------------------
CASH, CHECK or MONEY ORDER
--------------------------
Please complete the following information and return this form with your
check or money order to the address below. Please make all checks and
money orders for U.S. funds payable to Gary L. Robinson.
Registration entitles you to use all future updates of PADHD without any
additional expense.
Please submit to: Gary L. Robinson
600 Apt. D. Mumford Dr.
Troy, OH 45373
USA
------------------------------------------------------------------
<Please Type or Print Clearly>
Name: ___________________________________________________________
Company: ________________________________________________________
Address: ________________________________________________________
________________________________________________________
City: _____________________ St or Prov: ________________________
Postal Code: ________________ Country: _________________________
Date: ___-___-______
IF MAILED AFTER DEC. 31, 1994 REGISTRATION FEE IS $35.00 per copy
I would like to register:
Totals
____ Copy(s) of PADHD @ $ 20.00 / 35.00 per copy: $______________
OHIO Residents add %5.5 for state sales tax: ____________________
I am including a check or money order for: ___________________
------------------------------------------------------------------