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Text File  |  1992-01-30  |  4KB  |  104 lines
  1.              InComm:PcPDial release 1.0.0 License/Registration Form
  2.              ======================================================
  3.                  Remit to: Futuresoft Technologies, PO Box 822,
  4.                           Hartselle, Alabama 35640 USA
  5.      ======================================================================
  6.           Qty       Item                     Per item price      Price
  7.           -----------------------------------------------------------------
  8.  
  9.           [  ]      InComm:PcPDial..............  $ 8.50 ea :    $_________
  10.  
  11.           (  )      ICEX user special offer, limit
  12.                     one per registered user.....  $ 5.00 :       $_________
  13.  
  14.                     ICEX registration number: __________________
  15.  
  16.           [  ]      Printed/Bound manual........  $ 8.00 ea :    $_________
  17.  
  18.           [  ]      Latest release disk(s)......  $ 2.00 ea :    $_________
  19.                                    --  OR  --
  20.           [  ]      Latest release disk(s) with 80286 
  21.                     version executables included. $ 3.00 ea :    $_________
  22.  
  23.                     Diskette media :   [  ] 3.5"   [  ] 5.25"
  24.  
  25.                Alabama resident state sales tax @ 4.00%........: $_________
  26.  
  27.      **********************************************************************
  28.  
  29.           Total...............................................:  $_________
  30.                (Checks must be drawn on a US bank, in US funds)
  31.  
  32.      **********************************************************************
  33.  
  34.           Name    : ______________________________________________
  35.  
  36.           Company : ______________________________________________
  37.  
  38.           Address : ______________________________________________
  39.  
  40.                     ______________________________________________
  41.  
  42.                     ______________________________________________
  43.  
  44.  
  45.  
  46.  
  47.      Check below the method by which you obtained Incomm:PcPDial:
  48.  
  49.                [ ] - Shareware Catalog/Vendor
  50.  
  51.                [ ] - User Group
  52.  
  53.                [ ] - Compuserve
  54.  
  55.                [ ] - Other online service
  56.  
  57.                      Which one? _________________________________
  58.  
  59.                [ ] - Electronic Bulletin Board System 
  60.  
  61.                      BBS Name/Number: ___________________________________
  62.  
  63.                [ ] - Other - Please Specify: ____________________________
  64.  
  65.                                              ____________________________ 
  66.  
  67.      **********************************************************************
  68.  
  69.      Your comments are appreciated:
  70.  
  71.           _________________________________________________________________
  72.  
  73.           _________________________________________________________________
  74.  
  75.           _________________________________________________________________
  76.  
  77.           _________________________________________________________________
  78.  
  79.           _________________________________________________________________
  80.  
  81.           _________________________________________________________________
  82.  
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  84.  
  85.           _________________________________________________________________
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  87.           _________________________________________________________________
  88.  
  89.           _________________________________________________________________
  90.  
  91.           _________________________________________________________________
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  95.           _________________________________________________________________
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