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Text File  |  1992-02-12  |  2KB  |  53 lines
  1.  
  2.                  ARCDIAG Registration & Comment Form 
  3.  
  4.  
  5.        
  6. Name:___________________________________________________________
  7.        
  8. Company:________________________________________________________
  9.  
  10. Address:________________________________________________________
  11.  
  12. City:__________________________ State:_____  ZIP _______________ 
  13.  
  14. Telephone:(_____) _____-_______     Date:_______________________
  15.  
  16. ARCDIAG Version:_____._____ 
  17.  
  18. Network Interface Card Types ___________________________________
  19.  
  20.  
  21. Comments: 
  22. _________________________________________________________________
  23. _________________________________________________________________
  24. _________________________________________________________________
  25. _________________________________________________________________
  26. _________________________________________________________________
  27. _________________________________________________________________
  28. _________________________________________________________________
  29. _________________________________________________________________
  30. _________________________________________________________________
  31. _________________________________________________________________
  32. _________________________________________________________________
  33.  
  34.  
  35. Payment Type:  Co. Purchase Order _____ or Check ______
  36.  
  37. Note: all funds must be in U.S. dollars
  38.  
  39. Quantity      Description     Cost Each
  40.  
  41. ________      ARCDIAG        ___$45.00___         sub-total ____.__
  42.  
  43.                shipping & handling ($3.00 U.S. $5.00 other) ____.__
  44.  
  45.                         (MI residents only) MI 4% Sales Tax ____.__
  46.  
  47.                                                       TOTAL ____.__
  48.  
  49.   Mail To:       Olympic Software Co
  50.                  8424 Warner Rd
  51.                  Saline, MI  48176
  52.  
  53.