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Text File  |  1993-02-23  |  2KB  |  56 lines
  1.  
  2.                         SUPER*SEARCH REGISTRATION FORM        
  3.                         ******************************
  4.                                    # 00004a
  5.  
  6.  
  7.       Name      ___________________________________________________
  8.  
  9.       Address   ___________________________________________________
  10.  
  11.       City      ___________________________________________________
  12.  
  13.       State     __________________    Zip     _____________________
  14.  
  15.  
  16.       Donation amount (USA)  $ ________
  17.  
  18.  
  19.       Where did you obtain this copy? _____________________________
  20.  
  21.       _____________________________________________________________
  22.  
  23.       _____________________________________________________________
  24.  
  25.       _____________________________________________________________
  26.  
  27.       Any Suggestions, comments, or criticism?
  28.  
  29.       _____________________________________________________________
  30.  
  31.       _____________________________________________________________
  32.  
  33.       _____________________________________________________________
  34.  
  35.       _____________________________________________________________
  36.  
  37.  
  38.       -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
  39.  
  40.  
  41.       Please fill in the above information. Make your donation check or 
  42.       money order payable to: Thomas Price.
  43.  
  44.       Send to:
  45.  
  46.                               Thomas Price
  47.                               P.O. Box 262
  48.                               Dedham,   MA
  49.                               02027
  50.  
  51.  
  52.       THANK YOU FOR YOUR SUPPORT!
  53.       
  54.  
  55.                  
  56.