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Text File  |  1994-05-14  |  2KB  |  54 lines
  1. -----------------------------------------
  2. REGISTRATION FORM FOR ArchiverX Version 1
  3. -----------------------------------------
  4.  
  5.  
  6. Name               ____________________________________________________________
  7. Adress             ____________________________________________________________
  8. City, St/Prov/Pref ____________________________________________________________
  9. Zip/Postal code    ____________________________________________________________
  10. Country            ____________________________________________________________
  11. Voice phone        +___________________________________________________________
  12. Data phone         +___________________________________________________________
  13.  
  14.  
  15. [*] ArchiverX Version 1 Registration (1 USD == 100 yen)          _____1,500 yen
  16.  
  17. [ ] Send registration key via E-Mail                                   ZERO yen
  18.  |- [ ] NetMail
  19.  |   +- [ ] FidoNet  [ ] OS2NET  Address ____________.0
  20.  +- [ ] E-Mail
  21.      |- [ ] Tokyo Online         Name ________________________
  22.      +- [ ] Tokyo BBS            ID   ________
  23.  
  24. [ ] Send registration key via Postal Services                    __________ yen
  25.  |- [ ] Japan residents             (add 100 yen)
  26.  |- [ ] Asia residents              (add 200 yen)
  27.  |- [ ] North/Mid America residents (add 250 yen)
  28.  |- [ ] Oceania residents           (add 250 yen)
  29.  |- [ ] Mid-east residents          (add 250 yen)
  30.  |- [ ] Europe residents            (add 300 yen)
  31.  |- [ ] South America residents     (add 300 yen)
  32.  +- [ ] Africa residents            (add 300 yen)
  33.  
  34.                                                        Subtotal: __________ yen
  35.  
  36. [ ] 3.0 percent consumption tax (Japan residents only)           __________ yen
  37.  
  38.                                                  Total enclosed: __________ yen
  39.  
  40. [ ] Money-order (recommended for overseas)
  41. [ ] Check (Japan residents)
  42. [ ] Bank transfer (Japan residents)
  43. [ ] Registered cash mail (Japan residents only)
  44.  
  45.  
  46. Please send this form with your registration fee to:
  47.  
  48.         Tsuneo Tanaka
  49.         75-3, Hatagaya 3-chome
  50.         Shibuya-ku, TOKYO
  51.         151 JAPAN
  52.  
  53. Please allow a few weeks for processing.
  54.