home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
DP Tool Club 19
/
CD_ASCQ_19_010295.iso
/
vrac_os2
/
scsvr101.zip
/
REGISTER.FRM
< prev
next >
Wrap
Text File
|
1994-11-26
|
5KB
|
60 lines
+----------------------------------------------------------------------------+
| Screen Saver Registration Form, Version 1.01A |
| |
| Please send your registration information (this form filled out) and |
| a check or money order for $10 to the following address: |
| |
| Vincent Greene |
| 200 N Melanie Lane |
| Tucson, AZ 85710 |
| |
| Please make all checks out to "Vincent Greene." |
| |
| If possible, please draw checks on a U.S. Bank in U.S. Funds. |
|----------------------------------------------------------------------------|
| |
| Your Name: _______________________________________________________ |
| |
| Address: _______________________________________________________ |
| |
| _______________________________________________________ |
| |
| City: ________________________________ State: ______________ |
| |
| Zip or Postal Code: _________________ Country: ______________ |
| |
| |
| OPTIONAL: (To be used in case of support needs) |
| |
| Home Phone: ____________________ Work Phone: ___________________ |
| |
| Email: _______________________________________________________ |
| |
| Note: If an Email address is provided, I will send your registration |
| information via Email and regular snail mail. I will also add |
| your Email address to a list to receive product updates and |
| other useful notices via Email. |
|----------------------------------------------------------------------------|
| The following information is optional and will only be used to determine |
| which BBS, FTP sites, and distributors should be provided with product |
| updates. |
| |
| Where did you get a copy of Screen Saver: ________________________ |
| |
| ____________________________________________________________________ |
| |
|----------------------------------------------------------------------------|
| Suggestions: |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
+----------------------------------------------------------------------------+