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/ Monster Media 1994 #2 / Monster Media No. 2 (Monster Media)(1994).ISO / business / trackit.zip / REGISTER.FRM < prev    next >
Text File  |  1994-08-15  |  1KB  |  57 lines
  1.  
  2.  
  3.                           Track-It Registration Form
  4.  
  5.  
  6.          Company Name: ______________________________________
  7.  
  8.          Contact Name: ______________________________________
  9.  
  10.          Shipping Address: __________________________________
  11.  
  12.          City: ______________________________________________
  13.  
  14.          State ______________________  Zip Code _____________
  15.  
  16.          Phone Number: (    ) ______ - ____________
  17.  
  18.          Serial Number of copy being registered _____________
  19.            (Found by pressing the F3 key at the main menu)
  20.  
  21.          Media Type:      3.5" HD disk( )   5.25" HD Disk ( )
  22.  
  23.  
  24.          Method of Payment:
  25.  
  26.          Check: ( )   Cashiers Check: ( )    Money Order: ( )
  27.           Visa: ( )       Mastercard: ( )                    
  28.  
  29.  
  30.          Card Number: _______________________________________
  31.  
  32.           Expiration: _______________________________________
  33.  
  34.         Name on card: _______________________________________
  35.            
  36.            Signature: _______________________________________
  37.         
  38.                                             Track-It $ 159.00
  39.  
  40.                                  Shipping & Handling $  10.00
  41.  
  42.                                  (CA only) 8.25% Tax $_______
  43.  
  44.                                             Total    $_______
  45.  
  46.  
  47.          Please make check payable to Millennium Software.
  48.          
  49.          Mail completed form and payment to:
  50.  
  51.          Millennium Software
  52.          P.O. Box 2209
  53.          Dublin, Ca. 94568
  54.  
  55.          
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  57.