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Text File  |  1993-05-01  |  2KB  |  55 lines
  1.  
  2.                     EMERI(tm) Version 1.3  Registration Form
  3.                     ----------------------------------------
  4.                          
  5.       Please check the appropriate item(s) below, and fill in the necessary
  6.       information.  Send your order form and payment (in U.S. Dollars) to:
  7.  
  8.                              Rhode Island Soft Systems, Inc.
  9.                              PO Box 748
  10.                              Woonsocket, RI  02895
  11.                              U.S.A.
  12.                              
  13.                              FAX: 401-658-4632
  14.                    Credit Card Orders: 1-800-959-RISS  (7477)
  15.                                    
  16.  
  17.   [ ] I would like to register _____ copies of EMERI Version 1.3
  18.       for only $16.95 (U.S.) each, and receive the most current version of
  19.       the program and files on diskette.  I will receive all of the
  20.       benefits of registration.   Disk size: [ ] 3.5"  or  [ ] 5.25"
  21.  
  22.   -------------------------------------------------------------------------
  23.  
  24.   1)  Subtotal for registrations (# of copies X $16.95)           $________
  25.  
  26.   2)  Optional Express Mail over night delivery add $10.95        $________
  27.   3)  Additional $10 (U.S.) for non-U.S. checks (when applicable) $________
  28.       (see the documentation for details)
  29.  
  30.   4)  Shipping and handling                                       $__5.00__
  31.  
  32.                                                Amount Enclosed    $________                                                                                            Amount enclosed    $________
  33.   
  34.  
  35.   [ ]  I have enclosed payment for the above amount.
  36.  
  37.   [ ]  Please charge my:  [ ] Visa   [ ] Mastercard   [ ] AmEx   [ ] Discover
  38.  
  39.        Signature:___________________________
  40.  
  41.        Card Number:______________________________ Expiry Date:_______________
  42.  
  43.  
  44.  
  45.   My name and mailing address is:
  46.  
  47.       Name: ____________________________________________________________
  48.  
  49.       Street/PO Box: ___________________________________________________
  50.  
  51.       City: ____________________  State: _______  Zip Code: ____________
  52.  
  53.       Phone Number: __________________   Fax Number: ___________________
  54.  
  55.