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Text File  |  1992-03-03  |  1KB  |  46 lines
  1.  
  2.             AC -The Archive Converter-
  3.                Donald M. Langhorne
  4.             South 5241 Columbia Avenue      
  5.                 Hamburg, NY 14075
  6.                   V2.13    
  7.                 Registration Form
  8.                 -----------------   
  9.  
  10.     Name:________________________________________________
  11.     
  12.     
  13.     Company:_____________________________________________
  14.  
  15.     
  16.     Address:_____________________________________________
  17.  
  18.     
  19.     Address:_____________________________________________
  20.         
  21.     
  22.     City:__________________________  State:____  Zip:__________-______
  23.  
  24.  
  25.     Comments:_________________________________________________________
  26.  
  27.     __________________________________________________________________
  28.     
  29.     __________________________________________________________________
  30.         
  31.         __________________________________________________________________
  32.  
  33.  
  34.  
  35.     Item             Quantity    Unit    Total                =====================================================
  36.  
  37.     Registration of AC      ________    *$10    ______    
  38.  
  39.     Copy of Latest Version    
  40.     of AC on diskette.    ________    *$5     ______  (Optional)
  41.  
  42.     Diskette Size    5.25:______    3.5:_____
  43.     Overseas Orders    Please add $1 per license    ______    
  44.  
  45.  
  46.                     Grand Total:    ______