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Text File  |  1996-09-20  |  2KB  |  51 lines
  1. Software Registration Form             Purchase Order     
  2.                                              Date:________
  3. ____________________________________________________________________
  4. Name:
  5. [1]
  6. [2]
  7. [3]
  8. Phone/FAX:   [4]       [5]
  9.  
  10. Email:   [6]
  11.  
  12. Comments:   [7]  
  13.  
  14. Payment Method..........:   [8]
  15. Purchase Order #.......:   [9][10][11]
  16.  
  17. Products Ordered:
  18. ([12]) QuickScrap ($15 each)........................:   [13]
  19. ([14]) ScrapIt Pro ($20 each).......................:   [15]
  20. ([16]) QuickScrap & ScrapIt Pro ($30 each):   [17]
  21. ([18]) QuickPop ($10 each)...........................:   [19]
  22. ([20]) ViewFont ($5 each)..............................:   [21]
  23. ([22]) ColorFall ($10 each)...........................:   [23]
  24. ([24]) Escape! ($10 each)..............................:   [25]
  25. ([26]) SideMinder ($10 each)........................:   [27]
  26.  
  27. Quantity Discount...........:   [28]
  28. Send Latest?...(adds $5):   [29]
  29. Disk Size (800k or HD):   [30]
  30. Sales Tax (CA Only).......:   [31]
  31. Note: Sales Tax is only
  32. collected if you've requested
  33. a disk and you live in
  34. California
  35.  
  36. Total Due.........................:   [32]
  37.  
  38. [33]
  39. ____________________________________________________________________
  40. Please send this form to:
  41.  
  42. John V. Holder                                                           Email addresses (AOL is preferred):
  43. 1734 "S" Street                                                         America Online:  JohnHolder
  44. Eureka, CA  95501                                                   Internet...........:  JohnHolder@aol.com
  45. USA                                                                            CompuServe....:  75040,1126
  46.  
  47. FAX:  (707) 443-3813
  48.  
  49. Home Page:   http://www.northcoast.com/~jvholder
  50. (check for the latest new releases and updates!)
  51.