home *** CD-ROM | disk | FTP | other *** search
/ Software Vault: The Diamond Collection / The Diamond Collection (Software Vault)(Digital Impact).ISO / cdr12 / golf94h.zip / GOLFLOG.ORD < prev    next >
Text File  |  1995-03-16  |  2KB  |  51 lines
  1.  
  2.                    .....   GolfLog Registration Form   .....
  3.  
  4. Remit To:  RiverBend SoftWare                       Tel: 501-563-2892
  5.            P.O. Box 671
  6.            Osceola, AR 72370-0671  USA
  7. =====================================================================
  8.  
  9. ____ GolfLog Registration(s) @ $32.95 each ............   ______.____
  10.  
  11. ____ GolfClub Registration(s) @ $98.95 each ...........   ______.____
  12.  
  13. ____ 3.5" disk instead of 5.25" ADD $3.00 .............   ______.____
  14.  
  15. ____ Shipping/Handling inside U.S.A. ($5.00/copy) .....   ______.____
  16.  
  17. ____ Shipping/Handling outside U.S.A. ($7.50/copy) ....   ______.____
  18.  
  19. ____ Arkansas residents (6.5% Tax per copy) ...........   ______.____
  20.  
  21.      TOTAL ............................................ $ ______.____
  22.  
  23.    ** Orders without S/H charges included will not be shipped! **
  24.  
  25. Check one:  [ ] Check/M.O.(U.S. bank)    [ ] Visa      [ ] MasterCard
  26.  
  27.  
  28.    Name: ____________________________________________________________
  29.                     (Name program is to be registered to)
  30.  
  31. Address: ____________________________________________________________
  32.  
  33.          ____________________________________________________________
  34.  
  35.    City: __________________________ State/Prov: _____________________
  36.  
  37. Country: __________________________ Zip/Postal Code: ________________
  38.  
  39. Home Phone  (____) ________________ Work Phone  (____) ______________
  40.  
  41.                       ..... Credit Card Information .....
  42.  
  43. Name on Card: _______________________________________________________
  44.                        (Must be exactly as shown on card)
  45.  
  46. Card Number:  _______  _______  _______  ________   EXPIRES ____/____
  47.                                                              MM / YY
  48. Signature:    _______________________________________________________
  49.                           Required if using Credit Card
  50. [v9.4h]
  51.