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Text File  |  1997-05-10  |  2KB  |  46 lines

  1.                  PURCHASE ORDER / REGISTRATION FORM
  2. I would like my own copy of SEA!  I understand that I will receive my
  3. own personalized version with which to register the SEA VIEWER software,
  4. and that by using SEA agree to all terms of the SEA licensing agreement
  5. contained in the SEA.DOC file. I also understand that SEA is protected by
  6. Federal Copyright Laws and International Treaty Provisions, and will
  7. not distribute my copy to anyone.  I understand that my correct phone
  8. number is required for registration and will be kept strictly
  9. confidential.  Optional items marked with asterisk (*).
  10.  
  11. YOUR NAME:___________________________________ *Company:___________________
  12. (PLEASE PRINT) First Name, Initial, Last name
  13.  
  14. Home Phone (_______) _______-________   *Work: (______) ______-___________
  15.  
  16. Addr:_____________________________________________________________________
  17.  
  18. City:_____________________________ State/Prov:_________ Zip:______________
  19.  
  20. Country:__________________________________________________________________
  21. How did you first discover SEA?___________________________________________
  22.  
  23. --------------------------------------------------------------------------
  24.                                            -QTY-  --PRICE--    --TOTAL--
  25.  
  26. SEA Viewer Registration(s)                  ___   US $29.95  $____________
  27. Shipping (inside US)                              US $ 3.00  $____________
  28. Shipping (outside US)                             US $ 8.00  $____________
  29. Sales Tax (8.25% - TX Residents Only)                        $____________
  30.                                                 ORDER TOTAL  $____________
  31.  
  32. Credit Card Number:    __VISA __MasterCard __AMEX __Discover __CHECK ENCL.
  33.  
  34. ________/________/________/________ Exp:____/____  Sign:X_________________
  35.  
  36. Send Orders to Photodex Corporation:
  37.    Internet/WWW:     http://www.photodex.com  (e-mail: sales@photodex.com)
  38.    CompuServe:       GO PHOTODEX              (e-mail: 74774,3570)
  39.    America On-Line:                           (e-mail: Photodex)
  40.  
  41. Voice: 1-800-37-PHOTO or 1-512-406-3020 (8:30-5:30 CST)
  42. Fax:   1-800-377-4676 or 1-512-452-6825
  43. Mail:  Photodex Corporation                   * Sales terms and pricing
  44.        1106 Clayton Lane, #200W                 are subject to change
  45.        Austin, Texas  78723                     without notice.
  46.