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Text File  |  1994-10-30  |  1KB  |  35 lines
  1. --------------------------------------------------------------------------------
  2. CORE REGISTRATION FORM
  3.  
  4.   Name:____________________________________________________________________
  5.  
  6.   Address:_________________________________________________________________
  7.  
  8.   City/State/ZIP:__________________________________________________________
  9.  
  10.   [no orders outside the US at current]
  11.  
  12.   Phone:(______)_____________________________
  13.  
  14.   Age:_________________ Occupation:________________________________________
  15.  
  16.   If you have an email address (Internet, Fidonet, Compuserve) write it on
  17.   the next line
  18.  
  19.   E-Mail:__________________________________________________________________
  20.  
  21.   Check here to indicate how you want to be notified about upgrades
  22.  
  23.      [  ] E-Mail   [  ] Snail-Mail    [  ] Don't contact
  24.  
  25.   Disk drive type: [  ] 3½ HD (1.44)  [  ] 5¼ HD (1.2)
  26.  
  27.                    [  ] 3½ DD (.7)    [  ] 5¼ DD (.3)
  28.  
  29.   Name Of Program:                HEXED
  30.   Cost:                           $15.00
  31.  
  32.   Please make all checks payable to Graham Ollis
  33.  
  34. --------------------------------------------------------------------------------
  35.