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Text File  |  1989-08-29  |  2KB  |  59 lines
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  5.  
  6.                         FLU_SHOT+ (V1.7) Registration
  7.  
  8.         Please fill out this form, then mail it along with a check for
  9.         $14 ($10 Registration, $4 Shipping/Handling/Processing) (or 
  10.         more!) to:
  11.  
  12.                                 Ross M. Greenberg
  13.                                 Software Concepts Design
  14.                                 594 Third Avenue
  15.                                 New York, New York 10016
  16.  
  17.         Thanks for your support!
  18.  
  19.         Name:_________________________________________________________
  20.  
  21.         Title:________________________________________________________
  22.  
  23.         Company:______________________________________________________
  24.  
  25.         Address:______________________________________________________
  26.  
  27.                 ______________________________________________________
  28.  
  29.         City:   _____________________     State: _________  Zip:______
  30.  
  31.         Telephone:__________________________________
  32.  
  33.         Comments and Suggestions:____________________________________________________
  34.  
  35.                  ____________________________________________________________________
  36.  
  37.                  ____________________________________________________________________
  38.  
  39.                  ____________________________________________________________________
  40.  
  41.                  ____________________________________________________________________
  42.  
  43.  
  44.         Where did you get FLUSHOT+ (V1.7) from? (check one, fill in the blank):
  45.  
  46.                 [__]  User Group  (which one:________________________________________)
  47.  
  48.                 [__]  BBS  (Name:_______________________)(Tel #:_____________________)
  49.  
  50.                 [__]  Other (Such as:________________________________________________)
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  52.  
  53.         Please send me more information on:
  54.  
  55.                 [__]  RamNet, the background communications program
  56.  
  57.                 [__]  The Programmer's Co_operative
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