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Text File  |  1991-04-28  |  2KB  |  59 lines
  1. -------------------------------------------------------------------------------
  2.  
  3.                 FLU_SHOT+ (V1.5) Registration
  4.  
  5. Please fill out this form, then mail it along with a check for
  6. $14 ($10 Registration, $4 Shipping/Handling/Processing) (or
  7. more!) to:
  8.  
  9.                         Ross M. Greenberg
  10.                         Software Concepts Design
  11.                         594 Third Avenue
  12.                         New York, New York 10016
  13.  
  14.  
  15. Thanks for your support!
  16.  
  17. Name:_________________________________________________________
  18.  
  19. Title:________________________________________________________
  20.  
  21. Company:______________________________________________________
  22.  
  23. Address:______________________________________________________
  24.  
  25.         ______________________________________________________
  26.  
  27. City:   _____________________     State: _________  Zip:______
  28.  
  29. Telephone:__________________________________
  30.  
  31. Comments and Suggestions:____________________________________________________
  32.  
  33.          ____________________________________________________________________
  34.  
  35.          ____________________________________________________________________
  36.  
  37.          ____________________________________________________________________
  38.  
  39.          ____________________________________________________________________
  40.  
  41.  
  42. Where did you get FLUSHOT+ (V1.5) from? (check one, fill in the blank):
  43.  
  44.         [__]  User Group  (which one:________________________________________)
  45.  
  46.         [__]  BBS  (Name:_______________________)(Tel #:_____________________)
  47.  
  48.         [__]  Other (Such as:________________________________________________)
  49.  
  50.  
  51. Please send me more information on:
  52.  
  53.         [__]  RamNet, the background communications program
  54.  
  55.         [__]  The Programmer's Co_operative
  56.  
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