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Text File  |  1989-01-12  |  2KB  |  65 lines

  1.    PAK version 1.5                                 Registration Form
  2.    -----------------------------------------------------------------
  3.      Make checks payable to:
  4.        NoGate Consulting
  5.        P.O. Box 88115
  6.        Grand Rapids, MI 49518-0115
  7.    -----------------------------------------------------------------
  8.  
  9.    Qty
  10.  
  11.    ___ Command line version of PAK        @ $15 each         $______
  12.  
  13.    ___ Full screen version of PAK (PAKF)  @ $30 each         $______
  14.  
  15.    ___ Programmer's version of PAK        @ $50 each         $______
  16.  
  17.                                                 Subtotal     $______
  18.  
  19.        Michigan residents please add 4% sales tax.           $______
  20.  
  21.        Shipping and handling - inside the United States        $3.50
  22.                                                               - or -
  23.                              - overseas                        $5.00
  24.  
  25.        Credit Card orders add 3% surcharge                   $______
  26.  
  27.                                                      Total   $______
  28.  
  29.      Diskette type (check or circle one):   [ ] 5.25"  [ ] 3.5"
  30.  
  31.      Payment: (check or circle one):
  32.  
  33.      [ ] Check  [ ] Money Order  [ ] Visa  [ ] MasterCard
  34.  
  35.      Credit Card #__________________________________________________
  36.  
  37.      Expiration Date _______  Signature ____________________________
  38.  
  39.      Credit Card Orders may be made by phone - (616)455-6270
  40.  
  41.    Checks and Money Orders must be drawn on U.S. banks in U.S. funds
  42.    -----------------------------------------------------------------
  43.  
  44.          Name_______________________________________________________
  45.  
  46.       Company_______________________________________________________
  47.  
  48.       Address_______________________________________________________
  49.  
  50.              _______________________________________________________
  51.  
  52.         Phone_________________________  Bus.________________________
  53.  
  54.     Where did you obtain PAK?
  55.  
  56.              _______________________________________________________
  57.  
  58.      Comments_______________________________________________________
  59.  
  60.              _______________________________________________________
  61.  
  62.              _______________________________________________________
  63.  
  64.    -----------------------------------------------------------------
  65.