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Text File  |  1993-11-03  |  3.5 KB  |  108 lines
  1.  
  2. ---------------------------------------------------------------------------
  3.                          ImHere Registration Form
  4. ---------------------------------------------------------------------------
  5.  
  6.   ■ NOTE !! ALL INFORMATION IN THIS DOCUMENT IS SUBJECT TO CHANGE WITHOUT ■
  7.   ■         PRIOR NOTICE !                                                ■
  8.  
  9.  
  10.           To register ImHere,  fill out the registration  form correctly and
  11.           send it  to :
  12.                           Serge Sozonoff
  13.               29 Ch Sur-le-Beau
  14.               1232 Confignon
  15.               SWITZERLAND
  16.  
  17.           Or send by FidoNet to 2:301/329
  18.  
  19.       For those who live in Switzerland the registration form can be sent
  20.           in by FAX or FIDO and you will receive your key by mail with a 
  21.           "Bulltin de versement" that you can pay at the Post Office.
  22.                   
  23.  
  24.           Prices are as follows :
  25.                     SFr. |  US $
  26.                     ------------
  27.             Non-commercial  15.- |  10.-
  28.                 commercial    30.- |  20.-
  29.  
  30.  
  31. ---------------------------------------------------------------------------
  32.                          ImHere Registration Form
  33. ---------------------------------------------------------------------------
  34.  
  35.          YOUR NAME : _______________________________ 
  36.  
  37.          REG NAME  : _________________________________  THIS WILL APPEAR IN
  38.                             IMHERE !! AS REGISTERED
  39.                             TO (Reg Name).
  40.  
  41.     POSTAL ADDRESS : ______________________________________________________
  42.  
  43.                      ______________________________________________________
  44.  
  45. VOICE PHONE NUMBER : ______________________
  46.  
  47.  NETWORK ADDRESSES : ____________________________________   (IF APPLICABLE)
  48.  
  49.   BBS PHONE NUMBER : ______________________                 (IF APPLICABLE)
  50.  
  51.                                 ___
  52. I WISH TO RECEIVE MY ORDER BY: |   | - FIDONET "CRASHMAIL"
  53.                                |___|
  54.  
  55.                                 ___
  56. I WISH TO RECEIVE MY ORDER BY: |   | - NORMAL MAIL
  57.                                |___|
  58.  
  59. If you choose mail then circle Floppy format  3.5"  or  5 1/4"    
  60.  
  61.  
  62. I HAVE ALSO SENT PAYMENT OF ________ IN THE FORM OF:
  63.                                 ___
  64.                                |   | - CASH
  65.                                |___|
  66.                                 ___
  67.                                |   | - PERSONAL CHECK *
  68.                                |___|
  69.                                 ___
  70.                                |   | - BANK TRANSFER **
  71.                                |___|
  72.  
  73.   *  MADE PAYABLE TO: Serge Sozonoff & add 5 US $ for bank expenses
  74.  **  Transfer : Union de Banque Suisses, Geneve 
  75.         Serge Sozonoff, Account : 335.677.M1 V
  76.  
  77.                                                 ____________________________
  78.                                                (SIGNATURE)
  79.  
  80.                MAIL TO:   Serge Sozonoff
  81.               29 Ch Sur-le-Beau
  82.               1232 Confignon
  83.               SWITZERLAND
  84.  
  85.  
  86.  
  87.  
  88. WHAT CHANGES OR ADDITIONS WOULD YOU LIKE TO SEE IN FUTURE VERSIONS?
  89.  
  90.              ____________________________________________________________
  91.  
  92.              ____________________________________________________________
  93.  
  94.              ____________________________________________________________
  95.  
  96.  
  97. DO YOU HAVE ANY ADDITIONAL COMMENTS?
  98.  
  99.              ____________________________________________________________
  100.  
  101.              ____________________________________________________________
  102.  
  103.              ____________________________________________________________
  104.  
  105.  
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  107.  
  108.