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Text File  |  1991-11-15  |  2KB  |  57 lines
  1.                       --------------------------------
  2.                       EASY-DOOR V2.0 REGISTRATION FORM
  3.                       --------------------------------
  4.  
  5.  
  6. First name      : ______________________________
  7.  
  8. Last name       : ______________________________
  9.  
  10. Address         : ____________________________________________
  11.  
  12. City            : ________________________
  13.  
  14. State/province  : ____________________
  15.  
  16. Country         : _________________
  17.  
  18. ZIP/postal code : _________________
  19.  
  20. Date            : _________________
  21.  
  22.  
  23. Where did you find Easy-Door? _______________________________________________
  24.  
  25.  
  26. Disk format (circle your choice) :    3' 1/2" (720k)   or   5' 1/4" (360k)
  27.  
  28.  
  29. Easy-Door       25$ (US) or 30$   (CAN) X  ___  = _____
  30.  
  31.  
  32.  
  33. ***********************************************************************
  34. Payment must be in US fund or Canadian fund. Check or money order only.
  35. ***********************************************************************
  36.  
  37.  
  38.  
  39. Comments: ___________________________________________________________________
  40.  
  41.           ___________________________________________________________________
  42.  
  43.           ___________________________________________________________________
  44.  
  45.           ___________________________________________________________________
  46.  
  47.           ___________________________________________________________________
  48.  
  49.  
  50.           
  51.                                 Martin Bouchard
  52.                                 1207 du Golf
  53.                                 Cap-Rouge, Quebec
  54.                                 CANADA
  55.                                 G1Y 2T4
  56.  
  57.