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Text File  |  1992-06-09  |  2KB  |  60 lines
  1. ANSIPLUS Version 2.0            Registration Form              June 1992
  2.  
  3. Required Information
  4. ====================
  5.  
  6.                      Your Name: ________________________________________
  7.  
  8.                   Company Name: ________________________________________
  9.  
  10. Registered Name (if different): ________________________________________
  11.  
  12.                Mailing Address: ________________________________________
  13.  
  14.                                 ________________________________________
  15.  
  16.                           City: ________________________________________
  17.  
  18.                 State/Province: __________  Zip/postal zone: ___________
  19.  
  20.         Country (if not U.S.):  ________________________________________
  21.  
  22.               Telephone Number: ____________________________
  23.  
  24.  
  25.         Media Type (check one): 3.5" DD____  5.25" HD____  5.25" DD____
  26.  
  27.   Number of copies ordered: __________        Quantity    Price per copy
  28.                                               --------    --------------
  29. Price per copy (see table): __________
  30.                                                   1           $39.00
  31.  Subtotal (price X copies): __________            2            35.00
  32.                                                   3            32.00
  33.                  Sales tax: __________            4            30.00
  34.                                                   5            28.00
  35.     Shipping ($2.00 outside
  36.      U.S. and Canada only): __________      Call for quantity, corporate
  37.                                             and site license pricing
  38.                      Total:
  39.                             ==========
  40.                                             Mail to:  Kristofer Sweger
  41. Please remit check or money order                     P.O. Box 378
  42. payable in U.S. dollars only.                         Larkspur, CA 94939
  43.                                                       (415) 924-5407
  44.  
  45. Optional Information
  46. ====================
  47.  
  48. How did you hear about ANSIPLUS? _______________________________________
  49.  
  50. Type of computer: ______________________  DOS version: _________________
  51.  
  52. Video controller: ______________________  Type of display: _____________
  53.  
  54. Comments: ______________________________________________________________
  55.  
  56. ________________________________________________________________________
  57.  
  58. ________________________________________________________________________
  59.  
  60.