home *** CD-ROM | disk | FTP | other *** search
/ Software Vault: The Diamond Collection / The Diamond Collection (Software Vault)(Digital Impact).ISO / cdr28 / rep122.zip / REGISTER.DOC < prev    next >
Text File  |  1995-03-09  |  4KB  |  133 lines
  1.  
  2.                   Stevenson Technical Services, Inc. (STSI)
  3.                             108 Second Avenue West
  4.                             Bertha, MN 56437-0297
  5.                           Phone/FAX: (218) 924-2050
  6.                      The STSI BBS: (218) 924-2060, N,8,1
  7.  
  8.                       Replicator 1.22 Registration Form
  9.  
  10.    Qty    Description                                   Price Each     Total
  11.  
  12.   _____   Replicator 1.22 Single-User Registration         $49.95   ________
  13.             Includes a printed manual, 3 1/2" & 5 1/4" diskettes,
  14.             removal of nag screens and 25-record database limit,
  15.             and a registration number good for all version 1.x
  16.             releases.
  17.  
  18.   _____   Replicator 1.22 Site-License (Users? ___)        ______   ________
  19.             (Same price breaks apply for site-licensing.)
  20.  
  21.            # of Users      Price           # of Users       Price
  22.            ----------     -------          ----------      -------
  23.                 5    ->   $150.00              50     ->   $600.00
  24.                10    ->   $300.00             100     ->   $750.00
  25.                20    ->   $450.00            More?    ->    CALL
  26.  
  27.  
  28.                                                        Sub-Total:   ________
  29.  
  30.                           Minnesota Residents Add 6.5% Sales Tax:   ________
  31.  
  32.         Shipping/Handling (USA/Canada = $5.00, Foreign = $10.00):   ________
  33.  
  34.                                                            Total:   ________
  35.  
  36.      Name: ____________________________  Company: __________________________
  37.  
  38.   Address: _________________________________________________________________
  39.  
  40.      City: ___________________________  State: _____  Zip Code: ____________
  41.  
  42.   Country: ___________________________  Phone: ______________________
  43.  
  44.   Please Register Replicator To This Name: _______________________________
  45.  
  46.  
  47.   Method of Payment: ___ Visa/MC   ___ American Express   ___ Discover
  48.                      ___ Check/Money Order Enclosed
  49.             (Checks/MO's must be in U.S. Funds drawn on a U.S. Bank!)
  50.  
  51.  
  52.   Credit Card #: _________________________________  Expiration Date: ___/___
  53.  
  54.   Name on Card: _______________________  Signature: ________________________
  55.  
  56.   Comments / Suggestions: __________________________________________________
  57.  
  58.   __________________________________________________________________________
  59.  
  60.   __________________________________________________________________________
  61.  
  62.  
  63.  
  64.  
  65.  
  66.                                      Page 1
  67.  
  68.   Please take a minute to answer the following questions.  Your answers
  69.   will assist us in improving and marketing Replicator.  (Check all that
  70.   apply.)
  71.  
  72.  
  73.   Where did you hear about Replicator?
  74.  
  75.   [ ] BBS             [ ] Catalog/Magazine    [ ] Friend/Relative
  76.   [ ] Rack Vendor     [ ] User's Group        [ ] Other _______________
  77.  
  78.   Please provide name of BBS/Catalog/Magazine/User's Group, (if possible)
  79.  
  80.   ______________________________________________________________________
  81.  
  82.  
  83.   What operating systems / environments do you use?
  84.  
  85.   [ ] DOS    [ ] Windows   [ ] OS/2    [ ] DESQview/DESQview/X
  86.  
  87.  
  88.   What do you use Replicator for?  _________________________________________
  89.  
  90.   __________________________________________________________________________
  91.  
  92.  
  93.   What feature(s) do you like the most about Replicator?  __________________
  94.  
  95.   __________________________________________________________________________
  96.  
  97.  
  98.   What feature(s) would you like to see added to Replicator?  ______________
  99.  
  100.   __________________________________________________________________________
  101.  
  102.  
  103.   Additional Comments:  ____________________________________________________
  104.  
  105.   __________________________________________________________________________
  106.  
  107.  
  108.   May We Quote You?    [ ] Yes    [ ] No    [ ] Doesn't Matter
  109.  
  110.  
  111.  
  112.  
  113.  
  114.  
  115.  
  116.  
  117.  
  118.  
  119.  
  120.  
  121.  
  122.  
  123.  
  124.  
  125.  
  126.  
  127.  
  128.  
  129.  
  130.  
  131.  
  132.                                      Page 2
  133.