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Text File  |  1991-09-03  |  2KB  |  68 lines
  1.       ActaeOn Version 2.00                         US Registration Form
  2.       -----------------------------------------------------------------
  3.         Make checks payable to:
  4.           Shareable Software International
  5.           P.O. Box 59102
  6.           Schaumburg               Credit Card registrations accepted
  7.           IL  60159                 Telephone  : 708-397-1221
  8.                                     Fax        : 708-397-0381
  9.       -----------------------------------------------------------------
  10.  
  11.       Quan       Item                             Price       Total
  12.  
  13.       ___  ActaeOn registration   ............... @ $39.95    ________
  14.  
  15.       ___  Shipping and handling   .............. @  $4.00    ________
  16.  
  17.            Sales Tax (Illinois residents only) .. @     7%    ________
  18.  
  19.  
  20.                                                       Total   ________
  21.  
  22.  
  23.       Checks or money orders in US dollars or Visa/Master Card accepted.
  24.       -----------------------------------------------------------------
  25.        Check enclosed ____ Visa ____ Master Card ____ (tick as approp.)
  26.  
  27.         Name on Card ________________________________________________
  28.  
  29.         Card Number ________________________________ Expires ________
  30.  
  31.  
  32.         Media 5.25" [  ]   3.5" [  ]     (Tick as appropriate)
  33.  
  34.           Name_______________________________________________________
  35.  
  36.        Company_______________________________________________________
  37.  
  38.        Address_______________________________________________________
  39.  
  40.               _______________________________________________________
  41.  
  42.               _______________________________________________________
  43.  
  44.          Phone_________________________  Bus.________________________
  45.  
  46.       Where did you obtain ActaeOn?
  47.  
  48.               _______________________________________________________
  49.  
  50.  
  51.       ActaeOn Serial Number   _______________________________________
  52.  
  53.       Comments_______________________________________________________
  54.  
  55.               _______________________________________________________
  56.  
  57.               _______________________________________________________
  58.  
  59.               _______________________________________________________
  60.  
  61.       What other shareware products would you be interested in?
  62.  
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  65.       -----------------------------------------------------------------
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