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Text File  |  1994-01-02  |  2KB  |  50 lines
  1.          REGISTRATION INVOICE FOR HIDIMG (C) SHAREWARE
  2.          ---------------------------------------------
  3. Make all checks/money orders out to or call with credit card order:
  4.                      FHS Supply Inc.
  5.                      PO Box 9
  6.                      Clover, SC 29710
  7.                      1-800-742-8484
  8.  
  9. Please fill out the form below:
  10.  
  11. Name:______________________________________________________________
  12.  
  13. Company:___________________________________________________________
  14.  
  15. Address:___________________________________________________________
  16.  
  17. City:__________________________ State:__________ Zip:______________
  18.  
  19. Country:_______________________ Telephone #:_______________________
  20.  
  21. Version # of HIDIMG you are currently using:________________
  22.  
  23. Where did you obtain your copy of HIDIMG?________________________
  24.  
  25. Prices are shown in US Dollars. Please ensure that your check is in
  26. US Dollars, drawn on a US bank.  Checks will be held until cleared.
  27.  
  28. Disk Size:  _____ (5 1/4" 1.2M)      _____ (3 1/2" 1.44M)
  29.  
  30. Quantity                          Price Ea.        Total
  31.  
  32. _______    HIDIMG Program         $24.95           _____
  33.  
  34.          SC Residents add 5%       $1.25           _____
  35.  
  36.          Shipping and Handling     $5.00           _____
  37.  
  38.                               Total Enclosed _____________
  39.  
  40. Credit Card orders (VISA/MasterCard/Discover/American Express):
  41.  
  42. NAME ON CARD:__________________________________________
  43.  
  44. Card #:___________________________________________
  45.  
  46. CARD EXPIRATION DATE:__________________________________
  47.  
  48. Authorizing Signature:____________________________________
  49.  
  50. Note: Prices are for SINGLE-COMPUTER licenses.