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Text File
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1991-08-21
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2KB
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58 lines
Registration Form
EMAIL ADDRESS:___________________________________________
NAME:____________________________________________________
ADDRESS:_________________________________________________
_________________________________________________
_________________________________________________
CITY:________________________ STATE:____ ZIP:____________
COUNTRY:____________
PHONE # (Data): ___ ____ ______________
(Voice): ___ ____ ______________
General info:
Machine type: 8088/6[_] 80286[_] 80386[_] 80486[_] Other[_]
Machine name: ________________________________________
Display type: MDA[_] CGA[_] Herc[_] EGA[_] MCGA[_] VGA[_] SVGA[_]
Card name:_____________________________________________
Floppy drives: 3½ 720k[_] 3½ 1.44M[_] 3½ 2.88M[_]
5¼ 360k[_] 5¼ 1.2M [_]
Modem speed: 1200[_] 2400[_] 4800[_] 9600[_] 19200[_] Other: ________
Modem name:_____________________________
Other configuration:_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
Driver type: Svga 256 ____ @ $20
Svga 16 ____ @ $20
Tweak 256 ____ @ $20
Tweak 16 ____ @ $30
Two drivers ____ @ $30 (check above)
Four drivers ____ @ $50
Do you want a copy of the source? _____
From September 1-May 8, please send checks/money to:
Jordan Hargrave
1000 Morewood Ave, Box #3277
Pittsburgh, PA 15213
(412) 268-4493
From May 8-September 1, send to:
Jordan Hargrave
1615 Burnley Road
Charlotte, NC 28210
(704) 553-2332