REGISTRATION FORM The Thompson Partnership Church Croft Bramshall UTTOXETER, Staffs ST14 5DE Tele +44 (0)889 564601 Fax +44 (0)889 563219 1) Circle a Registration Option: OPTION 1 - œ59.00 Registered Surefire (latest version) disks plus 6 months technical support, 460 page user's guide, demonstration and practice documents. OPTION 2 - œ24.00 Registered Surefire (latest version) disks plus 2 technical support calls, 3 months tech support by mail and demonstration Smart Documents. 2) Circle Disk Size: 5 1/4" 3 1/2" TOTAL AMOUNT ENCLOSED: œ____________ VISA, MC or AmEx Number :________________________________________ EXPIRATION DATE:______/_______ SIGNATURE___________________________ Please make checks payable to : The Thompson Partnership 4) Please fill out below: NAME____________________________ TITLE_______________ DATE__________ COMPANY_______________________________________ PHONE_______________ ADDRESS_____________________________________________________________ _____________________________________________________________ TOWN____________________________________ COUNTY_____________ Post Code___________ COUNTRY _______________________________ 5) Please answer these questions: 1. Your industry?_________________ 2. Job function? ______________ 3. Will you use Surefire at home or work? ________________________ 4. Number of PCs at this location? ____ Is there a network? ______ 5. Where did you learn about Surefire? ___________________________ 6. Where did you get your shareware copy of Surefire? ____________ 7. Comments (use back for more room) __________________________________________________________________ __________________________________________________________________