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Text File  |  1991-10-11  |  2KB  |  45 lines
  1.       Rock Utilities Order And Registration Form (from RIR 1.35)
  2.  
  3.  
  4.      Name:          _______________________________________
  5.  
  6.      Address:       _______________________________________
  7.      
  8.                     _______________________________________
  9.      
  10.      City:          _______________________________________
  11.      
  12.      State:         ________________________ Zip: _________
  13.      
  14.      Daytime phone: __________  Evening phone: ____________
  15.      
  16.      Best time to reach you: ______________________________
  17.  
  18.      Item                                      Quantity    Total
  19.      -----------------------------------------------------------
  20.                                                        |
  21.      Rock Utilities Registration ($20 each)____________|_________
  22.                                                        |
  23.      Disk update for registered users ($5 each)________|_________
  24.                                                        |
  25.      Shipping Charges         U.S./Canada : $ 2.00     |
  26.                               Elsewhere   : $ 5.00     |
  27.                                                        |
  28.      Total Shipping Charges____________________________|_________
  29.                                                        |
  30.      ------------------------------------------------------------
  31.                                                        |
  32.      Total Due:                                        |_________
  33.      
  34.      Preferred Disk Size (circle one):   3.5"   5.25"
  35.      
  36.      Do you use a modem with your PC? ___________________________
  37.      
  38.      Where did you hear about the Rock Utilities? _______________
  39.      
  40.      Mail completed form to:  Rock Systems
  41.                               101 N. Main St., Suite 150-125
  42.                               Ann Arbor, MI  48104
  43.  
  44.           *** Checks should be payable to "Rock Systems" ***
  45.