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Text File  |  1993-09-24  |  1KB  |  63 lines
  1.  
  2.              HAZEL REGISTRATION FORM
  3.  
  4.  
  5. To register your copy of Hazel, please mail the following information
  6. with a check or money order drawn on a U.S. bank to:
  7.  
  8.  
  9.             Golden Richard III
  10.             2641 Sandbury Blvd.
  11.             Columbus, OH  43235
  12.  
  13.  
  14. --------------------------------cut here------------------------------------
  15.  
  16. Please type or print clearly:
  17.  
  18.  
  19.      Date: _______________
  20.  
  21.     
  22.      Name:    __________________________________________________
  23.  
  24.  
  25.      Company: __________________________________________________
  26.  
  27.     
  28.      Address: __________________________________________________
  29.  
  30.               __________________________________________________
  31.  
  32.  
  33.      City:    _____________________    State:    _______________
  34.  
  35.  
  36.      Zip:     _____________________    Country:  _______________
  37.  
  38.  
  39.      Phone Number:             ___________________________  [Work or Home?]
  40.  
  41.  
  42.      Email address (optional): ___________________________
  43.  
  44.  
  45.     
  46.      Disk preference:  < > 3.5"   < > 5.25"   [select one]
  47.  
  48.  
  49.  
  50.     ____ copies of Hazel v1.1 @ $ 29.00 per copy:         $___________
  51.  
  52.  
  53.     State of Ohio sales tax:                              $___________
  54.  
  55.  
  56.     Check or money order for                              $___________
  57.     is enclosed.
  58.  
  59.  
  60.  
  61. Comments & suggestions for improvement are appreciated.  Please
  62. include any comments on the back of this form.
  63.