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Text File  |  1991-05-09  |  2KB  |  59 lines
  1.  
  2.  
  3.  ┌────────────────────────────────────────────────────────────────────────────┐
  4.  │                          XLAGIT REGISTRATION FORM                          │
  5.  └────────────────────────────────────────────────────────────────────────────┘
  6.  
  7.  
  8.      NAME:__________________________________________________________
  9.  
  10.  
  11.      ADDRESS:________________________________________________________
  12.  
  13.  
  14.              ________________________________________________________
  15.  
  16.  
  17.              ________________________________________________________
  18.  
  19.  
  20.      PHONE: (______)  _______ - __________________
  21.  
  22.      DISK SIZE:  (check one)
  23.         ┌──┐                     ┌──┐
  24.         │  │ 3.5" (PS/2)         │  │ 5.25" (PC/XT/AT)
  25.         └──┘                     └──┘
  26.  
  27.      COMMENTS:______________________________________________________________
  28.  
  29.  
  30.      _______________________________________________________________________
  31.  
  32.  
  33.      _______________________________________________________________________
  34.  
  35.  
  36.      _______________________________________________________________________
  37.  
  38.  
  39.      _______________________________________________________________________
  40.  
  41.      =======================================================================
  42.  
  43.       In this letter I had included a money order of amount  $______.______
  44.       Payable to ATAKORN TANGTRAKUL.
  45.  
  46.      =======================================================================
  47.  
  48.       Send this form to:
  49.  
  50.                   ATAKORN TANGTRAKUL
  51.                   64 W. Main St.
  52.                   Somerville, NJ 08876
  53.  
  54.   
  55.  
  56.                                                         Thank you,
  57.                                                               Ut.
  58.  
  59.