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REGISTER.FRM
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1996-11-01
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▄█████▄ ██████▄ ▄█████▄ ▄██████ ▐██▌ ▄█████▄ ▄█████▄ (tm)
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Ver. 2.0
REGISTRATION FROM
Name:_________________________________________________________________________
Address:______________________________________________________________________
ZIP Code:_____________City:_____________________ Country:_____________________
Phone number:______________________________ Fax: _____________________________
E-mail (FidoNet, InterNet, Compuserve):_______________________________________
[ ] Yes, please send me a registered copy of Grafica(tm) library. I understand
that I can use this copy only for myself and only on ONE computer.
Number of registered copies: _______ x 40 USD$
+ 5 USD$ handling and shipping costs
____________________________________________
TOTAL:_______ USD$
I understand that I will receive the registered copy on a 3,5" (1.44Mb) disk
Today date:__________________ Signature:
Please send this form with the money to:
Gabriel Ciobotaru
Str. Izv. Crisului Nr. 7
Bl. A5, Sc. D, Ap. 55
75385, Bucharest, ROMANIA
or, for a secure shipping of the money, please send this form by fax
at +40-1-686.36.90 or e-mail gabriel@ysnet.pcnet.ro and send the money to
the bank account:
Bank name: BCIT ("Ion Tiriac" Commercial Bank S.A)
Telex: 11573 bcit r
Account number: 45.30 1294 30
Name: Ciobotaru Mariana
City, Country: Bucharest, ROMANIA
NOTE! If you send the money by bank transfer, please send to the name
Ciobotaru Mariana.
* If you want to receive the FULL source code from ALL Grafica units, please
ask !