home *** CD-ROM | disk | FTP | other *** search
/ Monster Media 1996 #14 / Monster Media No. 14 (April 1996) (Monster Media, Inc.).ISO / bbs_door / vfy_39.zip / REGISTER.FRM < prev    next >
Text File  |  1996-02-11  |  1KB  |  57 lines

  1. Sagerquist Micro Engineering                   VERIFY!.EXE  v3.9
  2. 1414 W. Kerrick St.                            Registration Form
  3. Lancaster, Ca. 93534
  4. Data BBS (805) 723-6908                         Date:___________
  5.  
  6.  
  7.  
  8.     Name:___________________________________________________
  9.  
  10.  
  11.     Address:________________________________________________
  12.  
  13.  
  14.     City, St., Zip:_________________________________________
  15.  
  16.  
  17.     Internet/Online Service Address:________________________
  18.  
  19.  
  20.     BBS Software:___________________________________________
  21.  
  22.  
  23.     BBS Phone Number:_______________________________________
  24.  
  25.  
  26.     VERIFY!.EXE registration is ....................  $15.00
  27.  
  28.     California residents add 8.25% ($1.24) Sales Tax:_______
  29.  
  30.     Make a check or money order payable to
  31.     Sagerquist Micro Engineering:            _______________
  32.  
  33.     From where did you receive your copy of VERIFY!.EXE?
  34.  
  35.  
  36.     ________________________________________________________
  37.  
  38.  
  39.     Comments or Suggestions?
  40.  
  41.     ________________________________________________________
  42.  
  43.     ________________________________________________________
  44.  
  45.     ________________________________________________________
  46.  
  47.     ________________________________________________________
  48.  
  49.     ________________________________________________________
  50.  
  51.     ________________________________________________________
  52.  
  53.     Thank you for your support.  
  54.  
  55. Carl Sagerquist
  56. Sagerquist Micro Engineering.
  57.