home *** CD-ROM | disk | FTP | other *** search
/ Libris Britannia 4 / science library(b).zip / science library(b) / MEDICAL / H417B.ZIP / REGISTER.FRM < prev   
Text File  |  1993-10-20  |  2KB  |  53 lines
  1.                          MEDPAS  REGISTRATION  FORM
  2.                          --------------------------
  3.  
  4. REGISTRATION CHARGES:
  5.  
  6.       1. United States - 19.00 US dollars  + 5.00 p&p
  7.                                 By cheque, VISA, MASTERCARD, or Money Order
  8.       2. England       - 12.00 UK pounds (Sterling equivalent) + 3.00 p&p
  9.                                 By cheque, VISA, MASTERCARD, EUROCARD, ACCESS,
  10.                                    or Money Order
  11.  
  12.    -------------------------------------------------------------------------
  13.  
  14. BY MAIL:
  15.  
  16.       From:____________________________            Date:_____________
  17.            ____________________________
  18.            ____________________________            Format wanted:
  19.            ____________________________                   3.5 or 5.25
  20.            ____________________________            Obtained from:
  21.                                                    __________________________
  22.       Texas Residents please add 5.44 for TAX.
  23.                               Circle type: VISA  MASTERCARD  ACCESS  EUROCARD
  24.  
  25.       I enclose ___________________       Card No____________________________
  26.  
  27.       For ___________ REGISTRATIONS       Exp Date___________
  28.  
  29.       MAIL TO:                            Signature__________________________
  30.  
  31.       Cambridge Technologies                   iDRSystems Ltd
  32.       PO BOX  589                              P.O. BOX 193
  33.       Riverside, TX  77367       OR            Peterborough
  34.       U.S.A                                    PE3 6TJ
  35.                                                ENGLAND
  36.  
  37.    -------------------------------------------------------------------------
  38.  
  39. BY TELEPHONE:  ( 24 hour telephone service )
  40.       A recording machine may be in operation during certain hours.
  41.       When ordering please speak clearly and spell your name and address if
  42.       necessary to avoid any mistakes. Do not forget to provide a return
  43.       telephone number, type, number, and expiration date of credit card.
  44.  
  45.       Cambridge Technologies
  46.       1.     800-487-6523                  Inside USA
  47.       2.     409-594-3355                  International or Texas
  48.       3.     0800-892-311                  From England
  49.  
  50.                By telephone, VISA and MASTERCARD only.
  51. --------------------------------------------------------------------------
  52. iDRSystems Ltd  Reg 2259568 :  Cambridge Technologies, a Texas Corporation.
  53.