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Text File  |  1996-05-29  |  2KB  |  47 lines
  1.  
  2. Yes!  Please send me the latest version of Personal Harmonograph Simulator,
  3.       with printer support, and make me a registered user of PHS.  Enclosed
  4.       is a check or money order, drawn on a U.S. bank, in U.S. dollars,
  5.       payable to "George Gesslein II".
  6.  
  7.                               Your Shipping Address
  8. -------------------------------------------------------------------------------
  9.  
  10.                         Name: _________________________________________________
  11.  
  12. Company (if company address): _________________________________________________
  13.  
  14.                      Address: _________________________________________________
  15.  
  16.                  City, State: _________________________________________________
  17.  
  18.              Zip/Postal Code: _______________________
  19.  
  20.                      Country: _______________________
  21.  
  22.                 Phone Number: _______________________
  23.  
  24. -------------------------------------------------------------------------------
  25.  
  26. Number of copies: _______ X $25.00 = ___________________________
  27. New York residents add 8% sales tax: ___________________________
  28.  
  29.                      Total enclosed: ___________________________
  30.  
  31. -------------------------------------------------------------------------------
  32.  
  33. Check disk format desired:    ___5.25" High Density
  34.                               ___3.5"  Low Density
  35.  
  36. -------------------------------------------------------------------------------
  37. Send to:             George Gesslein II
  38.                      RD#2 118 Sharpsteen Road
  39.                      Locke, New York  13092
  40. -------------------------------------------------------------------------------
  41.  
  42. Where did you get the shareware version of PHS?: ______________________________
  43.  
  44. Please enter your Internet address if you have one: ___________________________
  45.  
  46. Optional comments, suggestions, or questions:
  47.