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Text File  |  1992-01-02  |  2KB  |  60 lines
  1.  
  2.                 Mixed Word version 1.00 Registration Form
  3.                  =======================================
  4.  
  5.          Make checks or money
  6.               order payable to:   Eric Gagnon,
  7.                                   Guy Martin or both.
  8.                                   
  9.                        Ship to:   Pro-Ciel Enr.
  10.                                   2928 Nadeau
  11.                                   Fleurimont, Qc.
  12.                                   Canada, J1G 3S1
  13.  
  14.     =================================================================
  15.      Serial ID : 1003001
  16.  
  17.          Qty          Name
  18.      
  19.          ___   Mixed Word version 1.00        @ 15.00$ each _______ $
  20.  
  21.                Shipping and handling @ 3.00$ for first and
  22.                                    add 1.00$ for each other _______ $
  23.  
  24.                                                       Total _______ $
  25.      
  26.          Diskette type:  [  ] 5.25" (360K)   Language: [ ] French
  27.                          [  ] 3.5"  (720K)             [ ] English
  28.  
  29.       Note: You can check French and English if you want both, but
  30.             circle the language you use frequently.
  31.                  ======================================
  32.  
  33.     Name: __________________________________________________________
  34.  
  35.     Company Name: __________________________________________________
  36.  
  37.     Address: _______________________________________
  38.  
  39.              _______________________________________
  40.  
  41.              _______________________________________
  42.  
  43.              _______________________________________
  44.  
  45.     Phone Number:  (     ) _____ - _________
  46.  
  47.     Comments:_______________________________________________________
  48.  
  49.       ______________________________________________________________
  50.  
  51.       ______________________________________________________________
  52.  
  53.       ______________________________________________________________
  54.  
  55.  
  56.  
  57.         If you have comments, you want more informations or you want
  58.    to download the last update, call on Pro-Ciel BBS (819) 822-4357 in
  59.    the Estrie Area - 300/1200/2400 Bauds.
  60.