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AGREG.FRM
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1989-04-14
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Autograf Registration Form
Return to: Walter F. Smith
R.D. 1
Petersburg, NY 12138
Autograf verion 124
Quantity Price
Disk containing latest update and manual
and next update ($15) ________ ________
(Sales tax included where required.)
Shipping outside US ($5) ________ ________
Total enclosed ________
Please specify 5.25____ or 3.5____ diskette.
Check here to have us contact you about large quantity purchases _____.
Terms: All payments must be in U.S. funds, and must be made by check,
cashier's check, or money order. Personal checks may be subject to bank
clearance delay before shipment.
Name: _____________________________________________
Company: _____________________________________________
Address: _____________________________________________
_____________________________________________
_____________________________________________
Phone (optional): ( ) -
I have read and agree to abide by the Autograf license agreement:
(Signature) _____________________________________________________
Where did you get Autograf? ___________________________________________
Please use the back of this page for any comments or suggestions.
______________________________________________________________________________