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Text File  |  1996-09-20  |  1KB  |  53 lines
  1. Software Registration Form
  2. ____________________________________________________________________
  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:
  15. [8]
  16. [9]
  17. [10]
  18. [11]
  19.  
  20. Products Ordered:
  21. ([12]) QuickScrap ($15 each)..............:   [13]
  22. ([14]) ScrapIt Pro ($20 each).............:   [15]
  23. ([16]) QuickScrap & ScrapIt Pro ($30 each):   [17]
  24. ([18]) QuickPop ($10 each)................:   [19]
  25. ([20]) ViewFont ($5 each).................:   [21]
  26. ([22]) ColorFall ($10 each)...............:   [23]
  27. ([24]) Escape! ($10 each).................:   [25]
  28. ([26]) SideMinder ($10 each)..............:   [27]
  29.  
  30. Quantity Discount...........:   [28]
  31. Send Latest?...(adds $5)....:   [29]
  32. Disk Size (800k or HD)......:   [30]
  33. Sales Tax (CA Only).........:   [31]
  34. Note: Sales Tax is only
  35. collected if you've requested
  36. a disk and you live in
  37. California
  38.  
  39. Total Due...................:   [32]
  40.  
  41. [33]
  42. ____________________________________________________________________
  43. Email this registration form to:
  44.  
  45. John V. Holder                   Email addresses (AOL is preferred):
  46. 1734 "S" Street                  America Online:  JohnHolder
  47. Eureka, CA  95501                Internet......:  JohnHolder@aol.com
  48.                                  CompuServe....:  75040,1126
  49. FAX:  (707) 443-3813
  50.  
  51. Home Page:   http://www.northcoast.com/~jvholder
  52. (check for the latest new releases and updates!)
  53.