home *** CD-ROM | disk | FTP | other *** search
/ Frostbyte's 1980s DOS Shareware Collection / floppyshareware.zip / floppyshareware / GLEN / PCFD-100.ZIP / REGISTER.FRM < prev    next >
Text File  |  1991-03-17  |  1KB  |  49 lines

  1.  
  2.  
  3.  
  4.        Form                   PCFDIAL REGISTRATION                 10002
  5.  
  6.  
  7.        Make checks payable to:                         (U.S. funds only)
  8.                                Barn Owl Software
  9.                                   P.O. Box 74
  10.                               O'Fallon, IL  62269
  11.                                VOX: 618-632-7345
  12.                                FAX: 618-632-0023
  13.  
  14.                or use a credit card!  We take MasterCard & Visa.
  15.  
  16.  
  17.        Registration w/ manual   Qty:_______     @  $19.00     $_________
  18.  
  19.                        Illinois residents add 6.5% sales tax  $_________
  20.  
  21.                                                        TOTAL  $_________
  22.  
  23.  
  24.  
  25.        Volume discounts available  if you purchase three or more copies.
  26.        See the PCFDial user manual for details.
  27.  
  28.  
  29.  
  30.  
  31.        Name:    _____________________________________  Date: ___________
  32.  
  33.        Company: ________________________________________________________
  34.  
  35.        Address: ________________________________________________________
  36.  
  37.                 ________________________________________________________
  38.  
  39.  
  40.  
  41.  
  42.        If paying by credit card:        MasterCard ____     or Visa ____
  43.  
  44.        Card Nmbr: _______________________________   Expires: ___________
  45.  
  46.        Signature: __________________________________   Date: ___________
  47.  
  48.        Day phone: _______________________________
  49.