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register.frm
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1994-08-23
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3KB
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105 lines
XED Registration Form
,
_ /_ __. __ _ , , , __. __ _
_/_)_/ /_(_/|_/ (_</_(_(_/_(_/|_/ (_</_
XED v1.1b (C) Copyright 1993-94 David L. Dight
All Rights Reserved.
Send this form with your payment to:
P.O. Box 280, Kings Cross, N.S.W. 2011 AUSTRALIA
Fax orders: +61 2 233 2929
Enquiries: davidd@interconnect.com.au, CIS: 100033,2563
Terms
-----
Cheques - Drawn on Australian bank in Australian dollars only.
Cards - in $US, If mailed, signature preferred.
Cash - send $A20 note or $US10 + 5 notes
Notes
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Upon receipt of your payment you will be sent your validation
code. This will remove the nag screen from the current copy of
XED that you have and enable additional functions.
The basic registration does NOT include a copy of the software
on diskette. Please indicate below if you require diskettes
and add the disk postage accordingly.
Site licences are available for +25 users. Please contact me
for details.
---------------------------------[ cut here ]-----------------------------------
XED v1.1b REGISTRATION FORM
Name __________________________________ Date ________________________
Street Address ______________________________________________________
City ____________________ State __________ Zip/Post Code ___________
Country ________________________ Phone ______________________________
E-mail ______________________________________ Computer ______________
HDD Capacity ___________ Video adaptor ______ Type of use ___________
Where did you find XED ? ____________________________________________
PAYMENT DETAILS
Cash Enclosed ____________ Cheque Enclosed _______________ ($A only)
MasterCard ____ VISA ____ AMEX ____ AMEX Authority # __________
Expiration Date _________________________
Card Number _________________________________________________________
Name on Card ________________________________________________________
Card Holder's Signature _____________________________________________
Disks _____ FD Format ________ @ 4.50 ea. $US __________
(includes p/h)
Copies _____ 1 ID per copy, 1-5 @ 15.00 ea. $US __________
Copies _____ 1 ID per copy, 6-25 @ 12.50 ea. $US __________
------------------------------------------->> Total = $US __________