home *** CD-ROM | disk | FTP | other *** search
/ Current Shareware 1994 January / SHAR194.ISO / email / robom12a.zip / ORDER.FRM < prev    next >
Text File  |  1993-08-29  |  4KB  |  104 lines

  1.  
  2.  
  3.      ================================
  4.       ROBOMAIL 1.2 REGISTRATION FORM
  5.      ================================
  6.  
  7.      Remit to:  Parsons Consulting
  8.                 5020 S. Lake Shore Drive
  9.                 Suite 3301
  10.                 Chicago, IL  60615-3249
  11.                 U.S.A.
  12.  
  13.      ------------------------------------------------------------------
  14.      | Item                          | Quantity |  Price |    Total   |
  15.      |-------------------------------|----------|--------|------------|
  16.      | RoboMail version 1.2          | ________ | $35.00 | __________ |
  17.      |                               |          |        |            |
  18.      | RoboMail/Robocomm package     | ________ | $65.00 | __________ |
  19.      |                               |          |        |            |
  20.      | Shipping (Outside U.S. only)  | ________ |  $5.00 | __________ |
  21.      |---------------------------------------------------|------------|
  22.      |                                                   |            |
  23.      |   Total amount enclosed                           | __________ |
  24.      ------------------------------------------------------------------
  25.  
  26.      Check desired disk format:    ( ) 5.25"         ( ) 3.5"
  27.                   Disk Density:    ( ) Low Required  ( ) High
  28.  
  29.      Payment by:  ( ) Check or money order (U.S. funds only)
  30.                   ( ) MasterCard
  31.                   ( ) Visa
  32.                   ( ) PO # ______________
  33.  
  34.      Card #: ____________________________________  Exp. Date: _________
  35.  
  36.  
  37.  Signature of card holder: ____________________________________________
  38.  
  39.  
  40.      Name:     ________________________________________________________
  41.  
  42.      Company:  ________________________________________________________
  43.  
  44.      Address:  ________________________________________________________
  45.  
  46.                ________________________________________________________
  47.  
  48.                ________________________________________________________
  49.  
  50.      Phone:    ________________________________________________________
  51.  
  52.     FLASH:  INSTANT GRATIFICATION REGISTRATION ONLINE AT GROUP ONE BBS!
  53.             Call Group One BBS and register with MasterCard or Visa and
  54.             receive your personalized key file immediately!
  55.                             >>>> 312-752-1258 <<<<
  56.  
  57.  
  58.     INTERNATIONAL DISTRIBUTORS - RoboMail is now available directly
  59.     from distributors in several countries.  If you are currently
  60.     evaluating RoboMail and you live in one of the countries listed
  61.     below, please contact your distributor to register your copy of
  62.     RoboMail:
  63.  
  64.  
  65.         United Kingdom and Ireland
  66.         --------------------------
  67.  
  68.             Contact RoboMail UK on London 081-500 5000.
  69.             VISA/Access/MasterCard or EuroCard accepted
  70.  
  71.  
  72.         Australia and New Zeland
  73.         ------------------------
  74.  
  75.             My Computer Company
  76.             25 Albert Street (P.O. Box 99)
  77.             Erskineville  NSW  2043
  78.             AUSTRALIA
  79.  
  80.             Phone:  (02) 565-1991
  81.             Fax:    (02) 550-4459
  82.             BBS:    (02) 565-1044
  83.  
  84.             The Fidonet RoboMail support conference is available in
  85.             Australia through the My Computer Company BBS (3:712/411)
  86.             and the latest copy of RoboMail can be file requested using
  87.             the magic name ROBOMAIL.
  88.  
  89.  
  90.         South Africa
  91.         ------------
  92.  
  93.             Fincompt Technologies
  94.             P.O. Box 4472
  95.             Randburg
  96.             2125
  97.             SOUTH AFRICA
  98.  
  99.             Contact:    Ian Gerada
  100.             Phone:      +27 11 789-6192
  101.             Fax:        +27 11 789-6081
  102.             BBS:        +27 11 789-6085  (Netline Flagship)
  103.  
  104.