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Text File  |  1994-01-13  |  4KB  |  54 lines
  1. ┌──────────────────────────────────────────────────────────────────────┐
  2. │                                                                      │
  3. │ Return to:     Fugue Software        WORD FUGUE V3.1 REGISTRATION    │
  4. │                P.O. Box 425                                          │
  5. │                CAPALABA QLD  4157                                    │
  6. │                AUSTRALIA                                             │
  7. │                                                                      │
  8. │ Name ______________________________________________________________  │
  9. │                                                                      │
  10. │ Company ___________________________________________________________  │
  11. │                                                                      │
  12. │ Address ___________________________________________________________  │
  13. │                                                                      │
  14. │         ___________________________________________________________  │
  15. │                                                                      │
  16. │ Phone _____________________________________________________________  │
  17. │                                                                      │
  18. │ My Word Fugue serial number is (REQUIRED): ________________________  │
  19. │                                                                      │
  20. │ Diskette size:     ____ 5.25" acceptable       ____ 3.5" required    │
  21. │                                                                      │
  22. │                                               Quantity   Price       │
  23. │                                                                      │
  24. │ Word Fugue V3                  ($75/copy):    ________   __________  │
  25. │ (including manual & disks & one large dictionary,                    │
  26. │  special version for 386/486, document templates)                    │
  27. │ Word Fugue V3 disks only       ($40/set ):    ________   __________  │
  28. │ Word Fugue V3 manual only      ($35/copy):    ________   __________  │
  29. │ Additional Dictionary           ($5/copy):    ________   __________  │
  30. │ [ ]Australian   [ ]American   [ ]British                             │
  31. │ Subtotal                                                 __________  │
  32. │                                                                      │
  33. │ Shipping charges, per copy:                   ________   __________  │
  34. │                            Postage                                   │
  35. │     Registration     Australia    New Zealand   USA   Europe         │
  36. │     ------------     ---------    -----------   ---   ------         │
  37. │ Disks Only     $40       $3          $3         $5       $6          │
  38. │ Manual Only    $35       $5          $6         $9      $10          │
  39. │ Disks & Manual $75       $5          $7         $9      $10          │
  40. │                                                                      │
  41. │ Total enclosed:                                          __________  │
  42. │                                                                      │
  43. │ I wish to pay by:                                                    │
  44. │     [ ]   Visacard                     [ ]   Cheque                  │
  45. │     [ ]   Mastercard                   [ ]   Bankcard (Australia)    │
  46. │                                                                      │
  47. │Credit Card:  __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __   │
  48. │                                                                      │
  49. │ Expiry Date:  ___/___ Name: _________________________________________│
  50. │                                                                      │
  51. │                                                                      │
  52. │ Signature :                                                          │
  53. └──────────────────────────────────────────────────────────────────────┘
  54.