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ORDERFRM.DOC
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1994-04-23
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2KB
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72 lines
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REGISTRATION FORM
PADHD ver. 1.00
Copyright (c) 1994 by Gary L. Robinson
-----------------
This order form is for use by individuals wishing to become registered
users of PADHD. Corporations and other institutions, please contact me
for further information regarding site licenses and volume discounts.
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CASH, CHECK or MONEY ORDER
--------------------------
Please complete the following information and return this form with your
check or money order to the address below. Please make all checks and
money orders for U.S. funds payable to Gary L. Robinson.
Registration entitles you to use all future updates of PADHD without any
additional expense. This applies to individuals not to corporations or
other institutions.
Please submit to: Gary L. Robinson
600 D. Mumford Dr.
Troy, OH 45373
USA
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<Please Type or Print Clearly>
Name: ___________________________________________________________
Company: ________________________________________________________
Address: ________________________________________________________
________________________________________________________
City: _____________________ St or Prov: ________________________
Postal Code: ________________ Country: _________________________
Phone Number: ___________________________________________________
Date: ___-___-______
I would like to register:
Totals
____ Copy(s) of PADHD Ver. 1.00 @ $ 20.00 per copy: $______________
OHIO Residents add %5.5 for state sales tax: ____________________
I am including a check or money order for: ___________________
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