Software Registration Form
____________________________________________________________________
Registration information:
[1]
[2]
[3]
Phone/FAX:   [4]       [5]

Email:   [6]

Comments:   [7]  

Payment Method:   [8][9][10][11]

Products Ordered:
([12]) TakeABreak 2.0 ($10 each).................:   [13]
([14]) QuickScrap ($15 each)........................:   [15]
([16]) ScrapIt Pro ($20 each).......................:   [17]
([18]) QuickScrap & ScrapIt Pro ($30 each):   [19]
([20]) QuickPop ($10 each)...........................:   [21]
([22]) ViewFont ($5 each)..............................:   [23]
([24]) ColorFall ($10 each)...........................:   [25]
([26]) Escape! ($10 each)..............................:   [27]
([28]) SideMinder ($10 each)........................:   [29]

Quantity Discount...........:   [30]
Send Latest?...(adds $5):   [31]
Disk Size (800k or HD):   [32]
Sales Tax (CA Only).......:   [33]
Note: Sales Tax is only collected if you've requested a disk and you live in California

Total Due.........................:   [34]

[35]
____________________________________________________________________
Print this form and send your check, money order (made payable to “John V. Holder”) or cash to:

John V. Holder                                                           Email addresses (AOL is preferred):
1734 "S" Street                                                         America Online:  JohnHolder
Eureka, CA  95501                                                   Internet...........:  JohnHolder@aol.com
USA                                                                            CompuServe....:  75040,1126

FAX:  (707) 443-3813

Home Page:   http://www.northcoast.com/~jvholder
(check for the latest new releases and updates!)