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register.frm
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1994-07-17
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2KB
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51 lines
Kitchen Assistant Registration Order Form
Today's Date: _________________
Name: _____________________________________________________________
Company (if applicable): __________________________________________
Address: __________________________________________________________
__________________________________________________________
City: ____________________________ State: ___ Zip code: __________
Country: _________________________
Email address: ____________________________________________________
===================================================================
Registration Information
Registration Name (if other than name above)
__________________________________
Version being registered: ________________
====================================================================
Registration Only $20.00 _____
Registration and diskette $28.00 _____
Diskette only $10.00 _____
TOTAL _____
US & Canada Shipping included in above prices.
Enclosed: ____ Check ____ Money Order
Authorized Signature: ___________________________ Date: _________
Send form with Check or Money Order ( Sorry no credit cards) to:
Allan Nancoz
349 Quincy Avenue
Bronx, NY 10465-3011
Internet Address: anancoz@pipeline.com