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Text File  |  1996-06-05  |  2KB  |  53 lines
  1.  
  2. Aztech New Media Corporation Warranty Registration
  3. --------------------------------------------------
  4.  
  5. Name:      (Mr./Ms.)____________________________________________________________
  6.  
  7. Address: _____________________________________________________________________
  8.  
  9. Company: _________________________ Position: _________________________________
  10.  
  11.                  _____________________________________________________________________
  12.  
  13. City:      ___________________ Prov./State: _____ PC/Zip: ______________________
  14.  
  15. Country: _____________________________________________________________________
  16.  
  17. Telephone: _____________ Fax: ________________ Internet: _____________________
  18.  
  19. Product to be registered ____________________ Purchase Date: _________________
  20.  
  21. Purpose for buying this product? _____________________________________________
  22.  
  23.  
  24. Please put me on your mailing list for vip     Where was this product purchased?
  25. offers and new product announcements:
  26.                                                                                          _________________________________
  27. Yes                     No
  28.                                                                                          _________________________________
  29.  
  30. Type of Computer:              Peripheral Devices:            Do you have Children?
  31. PC:                                          Color Printer:                     Yes
  32. MAC:                                         Modem:                                     No
  33.  
  34. Other(please specify) ________________________________________________________
  35.  
  36.  
  37. Product Preferences:         Please Grade This Product:                     Buyer     User
  38. Photo Images                         A (highest)                                    Male        _____     _____
  39. Clip Art (line art)          B                                                        Female    _____     _____
  40. Video                                      C                                                        Age         _____     _____
  41. Animation                              D
  42. Music/Sound Effects          F (lowest)
  43.  
  44.  
  45. Other (please specify) _______________________________________________________
  46.  
  47.  
  48. Comments:_____________________________________________________________________
  49.  
  50.  
  51. ______________________________________________________________________________
  52.  
  53.