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Text File  |  1990-03-20  |  2KB  |  49 lines
  1.                   BAR TENDER REGISTRATION FORM
  2.  
  3. NAME: ______________________________________________________
  4.  
  5. COMPANY:  __________________________________________________
  6.  
  7. ADDRESS:  __________________________________________________
  8.  
  9.           __________________________________________________
  10.  
  11. CITY:     __________________________________________________
  12.  
  13. STATE:    ________________________  ZIP CODE:  _____________
  14.  
  15. PHONE:    __________________________________________________
  16.  
  17. E-MAIL ADDRESS:  ___________________________________________
  18.  
  19. WHERE DID YOU RECEIVE BAR TENDER?  _________________________
  20.  
  21. ____________________________________________________________
  22.  
  23. COMMENTS:  _________________________________________________
  24.  
  25. ____________________________________________________________
  26.  
  27.  
  28. Basic Registration @ $20.00                      $__________
  29.  
  30. Update Floppy Disk Service @ $5.00               $__________
  31.  
  32. Shipping outside U.S. @ $5.00                    $__________
  33.             (Payments MUST be in U.S. Dollars/U.S. Bank)
  34.  
  35.                                      SUBTOTAL:   $__________
  36.  
  37. Utah Residents Add 6.25% State Sales Tax
  38.        ($20 = $1.25 | $25 = $1.56)               $__________
  39.  
  40. Number of copies                                x___________
  41.  
  42.         1.45                            TOTAL:   $__________
  43.  
  44.         Remit to:         Kevin Vigor
  45.                           129 South 700 East #4
  46.                           Salt Lake City, Utah, 84102
  47.  
  48. 
  49.