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/ EnigmA Amiga Run 1998 July / EnigmA AMIGA RUN 29 (1998)(G.R. Edizioni)(IT)[!][issue 1998-07 & 08].iso / earkit / mail / smb / registration_form < prev    next >
Text File  |  1998-05-24  |  1KB  |  45 lines
  1.                   Super Mail Box V1.0 User Registeration Form
  2.        
  3.       Please PRINT clearly.
  4.        
  5.       Date:________________________
  6.       
  7.       Company Name:________________________________________________
  8.       
  9.       Email Address:_______________________________________________
  10.       
  11.       Last Name:________________ First Name:________________________
  12.       
  13.       Address:______________________________________________________
  14.       
  15.       City:______________ Prov/State:_____________ Zip:_____________
  16.       
  17.       Country:______________ Phone (Optional):______________________
  18.  
  19.       Please Fill In The Following:
  20.       
  21.         ___ $10.00 US Per Copy
  22.         
  23.         ___ $5.00 US unlimited free upgrades
  24.         
  25.         ___ Number of Copies
  26.         
  27.       ______ Total Amount
  28.       
  29.       Shipping:  ___ E-Mail    ___ Regular Mail
  30.       
  31.       If paying by cheque or money order please make
  32.       payable to: Danny Y. Wong and mail to:
  33.       
  34.       RE: Super Mail Box
  35.       
  36.       Danny Y. Wong
  37.       131 64 Ave. N.W.
  38.       Calgary, Alberta
  39.       T2K - 0L9 Canada
  40.        
  41.       Please allow 2 to 4 weeks for delivery
  42.       
  43.       THANK YOU FOR YOUR SUPPORT!!!
  44.  
  45.