  Problem Report Form (G7E19):

  Send to:   Synergistic Consultants, Incorporated
             Post Office Box 18888
             Huntsville, AL 35804-8888
             1-800-828-8384 (Order, help, fax line)

  Name:            __________________________________

  (Company):       __________________________________

  Address:         __________________________________

  City:            __________________________________

  Today's date:    ___________   

  State, ZIP Code: __________________________________

  (Country):       __________________________________

  Daytime
  Phone #: _________________________  FAX #: ____________________________
  Home
  Phone #: _________________________

  Hardware Platform:

  CPU: 8088 __ 286 __ 386 __ 486 __ 586 __
  Display: EGA __ VGA __  Color: __  Paper White: __
  Memory: ____ Kb
  Hard Disk? _____ Kb 3 1/2 Floppy? __ 5 1/4 Floppy? __
  Brand: ______________________________________________

  Operating System:

  DOS: Version: ______
  DR DOS: Version: _______
  Windows? ___________
  Other: ______________________________________________

  Software Version(s):
                                                Problem?
  GEN7 Desktop Version ___:                     ________
  Children's Tutors Version ___:                ________
  Accounting Module Version ___:                ________
  Music DataBase Version ___:                   ________
  Voice Module Version ___:                     ________
  Program Manager Version ___:                  ________
  Old Testament Evaluation Version ___          ________
  New Testament Evaluation Version ___          ________
  GEN7 User's Manual                            ________
  Evaluation Version? __
  Registration Number:                          ________

  Brief Synopsis of problem:

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