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FORM.DOC
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Text File
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1987-06-06
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4KB
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61 lines
------------------------------------------------------------------------
[ ]
[ Registration Form ]
[ ]
[ Date: __________ TO: P & M Software Co. ]
[ 9350 Country Creek #30 ]
[ Houston, Tx 77036 ]
[ ]
[ FROM: Name: ________________________________________ ]
[ ]
[ Address: ________________________________________ ]
[ ]
[ ________________________________________ ]
[ ]
[ ________________________________________ ]
[ ]
[ Phone # (_____)_______________________ ]
[ ]
[ ]
[ Check One: ]
[ ]
[ ____ Initial registration of "GT PowerComm" (suggest $50). ]
[ NOTE: initial registration includes an upgrade to current ]
[ version. ]
[ ____ Upgrade to current version of "GT PowerComm" (suggest $10). ]
[ If you are a registered user, you can use this option to ]
[ obtain an officially registered copy. ]
[ ]
[ PLEASE INDICATE SERIAL # AND VERSION OF PROGRAM YOU HAVE: ]
[ ]
[ Serial # __________ Version # 12.21 ]
[ ]
[ PLEASE INDICATE AMOUNT ENCLOSED: ]
[ Contribution Amount ........... __________ ]
[ ]
[ TX residents add sales tax .... __________ ]
[ ]
[ Total Enclosed ................ __________ ]
[ ]
[ PLEASE INDICATE METHOD OF PAYMENT: ]
[ If using major bank card, please indicate your card no., ]
[ expiration date and Interbank ID Number. ]
[ ]
[ ___ MasterCard (r) Interbank ID # ______________ ]
[ ___ Visa ]
[ ___ Check Credit Card No. ___________________________ ]
[ ___ Money Order ]
[ Expiration Date ______________ ]
[ Sales Tax Note ]
[ -------------- ]
[ To compute the proper sales tax you should include 5.25% for the ]
[ TX state tax, Houston residents should add 1% for the city sales ]
[ tax, and MTA residents should add an amount equal to their local ]
[ MTA rate. In Houston and Dallas, the MTA rate is 1%. ]
[ ]
[ Please DO NOT send cash. Send check, money order, or credit card ]
[ information. Your request will be filled promptly upon receipt. ]
------------------------------------------------------------------------