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Text File  |  1994-11-17  |  2KB  |  44 lines

  1.  
  2. ***************************************************************************
  3. *                                      *
  4. *            ***********************************              *
  5. *            **                     **              *
  6. *            ** DeliTracker Registration Form **              *
  7. *            **                     **              *
  8. *            ***********************************              *
  9. *                                      *
  10. *                                      *
  11. *  Name : ______________________________________________________________  *
  12. *                                      *
  13. *  Address : ___________________________________________________________  *
  14. *                                      *
  15. *  City : _____________________________ State: _________________________  *
  16. *                                      *
  17. *  Postal Code: _______________________ Country: _______________________  *
  18. *                                      *
  19. *                                      *
  20. *  Amiga model :  __________                          *
  21. *                                      *
  22. *  Kickstart __1.2  __1.3  __2.0  __3.0                      *
  23. *                                      *
  24. *  RAM : _____ MB FAST-RAM                          *
  25. *                                      *
  26. *     _____ MB CHIP-RAM                          *
  27. *                                      *
  28. *  Processor : 680__0                              *
  29. *                                      *
  30. *  Comments : __________________________________________________________  *
  31. *                                      *
  32. *  _____________________________________________________________________  *
  33. *                                      *
  34. *  _____________________________________________________________________  *
  35. *                                      *
  36. *  _____________________________________________________________________  *
  37. *                                      *
  38. *  _____________________________________________________________________  *
  39. *                                      *
  40. *  _____________________________________________________________________  *
  41. *                                      *
  42. *                                      *
  43. ***************************************************************************
  44.