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/ Monster Media 1996 #14 / Monster Media No. 14 (April 1996) (Monster Media, Inc.).ISO / utils / da_150.zip / REGISTER.FRM < prev    next >
Text File  |  1996-01-18  |  5KB  |  61 lines
  1.  +================= <**>  SHAREWARE REGISTRATION FORM  <**> ==================+
  2.  |                                                                            |
  3.  | Name   :___________________________________  Phone Number:________________ |
  4.  |                                                                            |
  5.  | Company:__________________________________________________________________ |
  6.  | (if applicable)                                                            |
  7.  | Address:__________________________________________________________________ |
  8.  |                                                                            |
  9.  | City   :_______________________________  St:______  Zip Code:_____________ |
  10.  |============================================================================|
  11.  |           DA Registration Fee:  $10.00 US   $15.00 International           |
  12.  |  Payment Type Enclosed:  [ ]-Check   [ ]-Money Order  (Do NOT send cash!)  |
  13.  | MAKE ALL CHECKS AND MONEY ORDERS PAYABLE TO JIM WILSON (See Address Below) |
  14.  |                                                                            |
  15.  |  (We don't accept credit cards, company PO's, or COD's at this time. All)  |
  16.  |  (registration payments must be drawn on a US bank and be in US dollars.)  |
  17.  |============================================================================|
  18.  |                                                                            |
  19.  | Program Name: ________________   Version: _______   Date:_____/_____/_____ |
  20.  |                                                                            |
  21.  | Where did you obtain this software from? (Circle Appropriate Number)       |
  22.  |   1. From a BBS?  (BBS name & phone #:___________________________________) |
  23.  |   2. From a distributor?  (Distributor name:_____________________________) |
  24.  |   3. From a friend?   (Relax, I won't make you tell me your friends name!) |
  25.  |   4. Somewhere else?  (Where:____________________________________________) |
  26.  |                                                                            |
  27.  | Is this for personal, business or technical use? _________________________ |
  28.  |============================================================================|
  29.  |                                                                            |
  30.  | Computer Make:________________________  Model:_____________  CPU:_________ |
  31.  |                                                                            |
  32.  | System RAM - Base:__________    Extended:__________    Expanded:__________ |
  33.  |                                                                            |
  34.  | Monitor Type:______________  Hard Drive:_______Meg  DOS Version:__________ |
  35.  |============================================================================|
  36.  | How do you Like my Program? ______________________________________________ |
  37.  |                                                                            |
  38.  | __________________________________________________________________________ |
  39.  |                                                                            |
  40.  | Have you Found any Bugs? _________________________________________________ |
  41.  |                                                                            |
  42.  | __________________________________________________________________________ |
  43.  |                                                                            |
  44.  | Any Incompatibilities? ___________________________________________________ |
  45.  |                                                                            |
  46.  | __________________________________________________________________________ |
  47.  |                                                                            |
  48.  | Suggestions for Upgrades:_________________________________________________ |
  49.  |                                                                            |
  50.  | __________________________________________________________________________ |
  51.  |                                                                            |
  52.  | Additional Comments:______________________________________________________ |
  53.  |                                                                            |
  54.  | __________________________________________________________________________ |
  55.  |============================================================================|
  56.  |                                                                            |
  57.  |  SEND ALL REGISTRATIONS, COMMENTS, AND INQUIRIES TO THE FOLLOWING ADDRESS  |
  58.  |                                                                            |
  59.  |     ConsulTech * Jim Wilson * 4 Scranton Pkwy * Oxford, NJ 07863 * USA     |
  60.  +============================================================================+
  61.