home *** CD-ROM | disk | FTP | other *** search
/ Shareware Grab Bag / Shareware Grab Bag.iso / 001 / gt1300_4.arc / FORM.DOC next >
Text File  |  1987-09-24  |  5KB  |  59 lines
  1.  
  2.      ------------------------------------------------------------------------
  3.      [                         Registration Form                            ]
  4.      [                                                                      ]
  5.      [   Date: __________                    TO:  P & M Software Co.        ]
  6.      [                                            9350 Country Creek #30    ]
  7.      [                                            Houston, Tx  77036        ]
  8.      [                                                                      ]
  9.      [   FROM:     Name: ________________________________________           ]
  10.      [                                                                      ]
  11.      [          Address: ________________________________________           ]
  12.      [                                                                      ]
  13.      [                   ________________________________________           ]
  14.      [                                                                      ]
  15.      [                   ________________________________________           ]
  16.      [                                                                      ]
  17.      [           Phone # (_____)_______________________                     ]
  18.      [                                                                      ]
  19.      [   CHECK DESIRED SELECTIONS:                                          ]
  20.      [                                                                      ]
  21.      [   ____ Initial registration of "GT POWER" (suggest $50).             ]
  22.      [           Includes an upgrade to latest version.                     ]
  23.      [   ____ Upgrade to current version of "GT POWER" (suggest $10).       ]
  24.      [           Registered users upgrade to latest version.                ]
  25.      [   ____ Enter standing order.  Available to credit card customers.    ]
  26.      [           All upgrades sent automatically.  Bug fixes free.          ]
  27.      [           Feature releases will be charged to customer at $10 ea.    ]
  28.      [                                                                      ]
  29.      [   PLEASE INDICATE SERIAL # AND VERSION OF PROGRAM YOU HAVE:          ]
  30.      [                                                                      ]
  31.      [             Serial # __________      Version #  13.00                ]
  32.      [                                                                      ]
  33.      [   PLEASE INDICATE AMOUNT ENCLOSED:                                   ]
  34.      [             Contribution Amount ........... __________               ]
  35.      [                                                                      ]
  36.      [             TX residents add sales tax .... __________               ]
  37.      [                                                                      ]
  38.      [             Total Enclosed ................ __________               ]
  39.      [                                                                      ]
  40.      [   PLEASE INDICATE METHOD OF PAYMENT:                                 ]
  41.      [       If using major bank card, please indicate your card no.,       ]
  42.      [       expiration date and Interbank ID Number.                       ]
  43.      [                                                                      ]
  44.      [   ___ MasterCard(r)    Interbank ID #  _____________                 ]
  45.      [   ___ Visa                                                           ]
  46.      [   ___ Check            Credit Card No. ___________________________   ]
  47.      [   ___ Money Order                                                    ]
  48.      [                        Expiration Date _____________                 ]
  49.      [   Sales Tax Note                                                     ]
  50.      [   --------------                                                     ]
  51.      [   To compute the proper sales tax you should include 5.25% for the   ]
  52.      [   TX state tax, Houston residents should add 1% for the city sales   ]
  53.      [   tax, and MTA residents should add an amount equal to their local   ]
  54.      [   MTA rate.  In Houston and Dallas, the MTA rate is 1%.              ]
  55.      [                                                                      ]
  56.      [   Please DO NOT send cash.  Send check, money order, or credit card  ]
  57.      [   information.  Your request will be filled promptly upon receipt.   ]
  58.      ------------------------------------------------------------------------
  59.