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Text File  |  1991-09-10  |  2KB  |  64 lines
  1.  ========================= ORDER/REGISTRATION FORM ============================
  2.  
  3.  Complete and send this form to:
  4.  
  5.                       ZABIKA INTERNATIONAL
  6.                       Zipcoder 1.22 Registration
  7.                       P.O. BOX 11593
  8.                       MILWAUKEE, WI 53211-3331.
  9.  
  10.  Note: U.S. funds only!
  11.  
  12.  ------------------------------------------------------------------------------
  13.  SINGLE COPY REGISTRATION
  14.  Disk with program and on-disk documentation  $20.00 ______ + $1.50 S&H
  15.  
  16.  Note: Overseas Order- Please add $6.00 for Shipping & Handling.
  17.  
  18.  ------------------------------------------------------------------------------
  19.  
  20.  SITE LICENSE (MULTIPLE-COPY) REGISTRATION
  21.  Site license for the use of ZIPCODER V1.22. (Includes one disk & on-disk docs)
  22.  
  23.           PCs                      Price
  24.       ---------------------------------------------------
  25.          2  - 10                  $17 each
  26.          10 - 20                  $15 each
  27.          20 - 30                  $13 each
  28.          40 - 50                  $10 each
  29.          51 or more               $750 one time fee.
  30.       ___________________________________________________
  31.  
  32.  Please add $2.50 for shipping & handling for each order.
  33.  (Overseas orders please add $6.00 per order)
  34.  
  35.  No. Copies:          _________
  36.  Shipping & Hand.:   $     2.50
  37.  Overseas:           $______.__ ($6.00 if applicable)
  38.  
  39.  Total enclosed:     $______.__
  40.  
  41.  Company Name (if applicable): ______________________________________________
  42.  
  43.  Your Name: _________________________________________________________________
  44.  
  45.  Address: ___________________________________________________________________
  46.  
  47.  City: _________________________ State: ___  Zip: ______  Country: ________
  48.  
  49.  Telephone: (    )___-____       Shareware Serial #: ____________
  50.  
  51.  Preferred disk type (check one): [ ] 720k [ ] 1.44M  [ ] 360k  [ ] 1.2M
  52.  
  53.  Computer/configuration: ____________________________________________________
  54.  
  55.  How and where did you find out about ZIPCODER V1.22? _______________________
  56.  
  57.  ____________________________________________________________________________
  58.  
  59.  Any comments and/or suggestions regarding ZIPCODER V1.22?
  60.  
  61.  ____________________________________________________________________________
  62.  
  63.  ____________________________________________________________________________
  64.