home *** CD-ROM | disk | FTP | other *** search
/ Media Share 9 / MEDIASHARE_09.ISO / graphics / makamess.zip / REGISTER.DOC < prev    next >
Text File  |  1993-03-05  |  1KB  |  30 lines
  1. ------------------------------------------------------------------------------
  2.  
  3.             Your Name: ______________________________________________
  4.  
  5.     Your Company Name: ______________________________________________
  6.  
  7.  Your Mailing Address: ______________________________________________
  8.  
  9.                        ______________________________________________
  10.  
  11.                        ______________________________________________
  12.  
  13.      Floppy Disk Size: ( )3.5" High Density    ( )3.5" Low Density
  14.                        ( )5.25" High Density   ( )5.25" Low Density
  15.  
  16.      Number of Copies: _______  ┌──────────────────────────────────────────┐
  17.                                 │ Prices: 1 Copy-$25, 2-5 Copies-$22 each  │
  18.                                 │         6-10 Copies-$20 each, 11 or more │
  19.                                 │         copies $19 each.                 │
  20. Total Amount Enclosed: $______  └──────────────────────────────────────────┘
  21.  
  22.  
  23. ------------------------------------------------------------------------------
  24.       Make your check or money order payable to: Russell Holloway.
  25.  
  26.                          The mailing address is: Russell Holloway
  27.                                                  305 Lindenhurst Drive
  28.                                                  Apartment 1138
  29.                                                  Lexington, KY  40509
  30.