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Text File  |  1993-10-22  |  1KB  |  40 lines
  1.  
  2.  
  3.                        ZCHECK REGISTRATION FORM
  4.  
  5.                                 MAIL TO
  6.  
  7.                        John Sims
  8.                        274 MacNab St.
  9.                        Dundas, Ontario
  10.                        Canada
  11.                        L9H 2K6
  12.  
  13.  
  14.         The cost is US $10.00. An additional US $2.00 will be needed 
  15.         for orders outside Canada and the US. See ZCHECK.DOC 
  16.         Registration section for more information. 
  17.  
  18.  
  19.  
  20.  
  21.         Name: ________________________________________________________
  22.  
  23.         Address: _____________________________________________________
  24.  
  25.         Address ( if needed ): ________________________________________
  26.  
  27.  
  28.         City, Prov., State: ___________________________________________ 
  29.  
  30.         Country: ______________________________________________________ 
  31.  
  32.         Postal Code, Zip Code Etc.: ___________________________________ 
  33.  
  34.  
  35.         ZCCHECK registration ( US $10.00 ) ..................$__________
  36.  
  37.         Additional Postage ( if needed ) ....................$__________
  38.  
  39.         Total................................................$__________
  40.