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REGISTER.FRM
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1993-10-20
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MEDPAS REGISTRATION FORM
--------------------------
REGISTRATION CHARGES:
1. United States - 19.00 US dollars + 5.00 p&p
By cheque, VISA, MASTERCARD, or Money Order
2. England - 12.00 UK pounds (Sterling equivalent) + 3.00 p&p
By cheque, VISA, MASTERCARD, EUROCARD, ACCESS,
or Money Order
-------------------------------------------------------------------------
BY MAIL:
From:____________________________ Date:_____________
____________________________
____________________________ Format wanted:
____________________________ 3.5 or 5.25
____________________________ Obtained from:
__________________________
Texas Residents please add 5.44 for TAX.
Circle type: VISA MASTERCARD ACCESS EUROCARD
I enclose ___________________ Card No____________________________
For ___________ REGISTRATIONS Exp Date___________
MAIL TO: Signature__________________________
Cambridge Technologies iDRSystems Ltd
PO BOX 589 P.O. BOX 193
Riverside, TX 77367 OR Peterborough
U.S.A PE3 6TJ
ENGLAND
-------------------------------------------------------------------------
BY TELEPHONE: ( 24 hour telephone service )
A recording machine may be in operation during certain hours.
When ordering please speak clearly and spell your name and address if
necessary to avoid any mistakes. Do not forget to provide a return
telephone number, type, number, and expiration date of credit card.
Cambridge Technologies
1. 800-487-6523 Inside USA
2. 409-594-3355 International or Texas
3. 0800-892-311 From England
By telephone, VISA and MASTERCARD only.
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iDRSystems Ltd Reg 2259568 : Cambridge Technologies, a Texas Corporation.