home *** CD-ROM | disk | FTP | other *** search
/ Der Mediaplex Sampler - Die 6 von Plex / 6_v_plex.zip / 6_v_plex / DISK4 / BUSIN_07 / MOM20.ZIP / ORDERFRM.TX_ / ORDERFRM.TX
Text File  |  1993-10-15  |  1KB  |  46 lines

  1.         Mom for Windows v2.0 Order/Registration Form
  2.  
  3.  
  4.             Date: _____________________
  5.  
  6.             Name: __________________________________________
  7.  
  8.     Company Name: __________________________________________
  9.  
  10. Shipping Address: __________________________________________
  11.  
  12.                   __________________________________________
  13.  
  14.                   __________________________________________
  15.  
  16. City: ____________________  State: ______  Zip: ____________
  17.  
  18. Phone Numbers:  ____________________________________________
  19.  
  20. E-Mail: ____________________________________________________
  21.  
  22. Floppy Diskette Size:        3.5 inches          5.25 inches
  23.  
  24.  
  25.  
  26. Where did you find this program? _______________________________________
  27.  
  28. Suggestions and Comments: ______________________________________________
  29.  
  30. ________________________________________________________________________
  31.     
  32. ________________________________________________________________________
  33.  
  34. ________________________________________________________________________
  35.     
  36. ________________________________________________________________________
  37.     
  38. ________________________________________________________________________
  39.     
  40.  
  41. Please print this form and send it along with $15 (US) to:
  42.                 
  43. Kyle Lutes Computing
  44. P.O.Box 267
  45. Bremen, IN  46506-0267
  46.