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Wrap
Text File
|
1992-04-15
|
1KB
|
43 lines
ShapeShifter(tm) Version 1.01 Registration
Name ______________________________________________________________
Address ______________________________________________________________
______________________________________________________________
City _______________________________ State _______ Zip ____________
Day Tel #: __________________ Eve Tel #: __________________
Amount $__________(15.00 Per Copy) Copies ____ Disk Format: _______
(staple check to bottom of page)
Signature: ____________________________________ Date: _______________
---------------------------------- fold here --------------------------------
(tape)
+-------+
| place |
| stamp |
| here |
+-------+
Curtis Little
2413 San Felipe Way
Modesto, CA 95355
---------------------------------- fold here --------------------------------