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Text File  |  1993-06-20  |  1KB  |  42 lines
  1.                   AutoChek v.2.0 Registration Form
  2.  
  3. Remit to:                  From:
  4.  
  5. Michael L. Torok                __________________________________
  6. 10101 Highway 9, #5             __________________________________
  7. Ben Lomond, CA 95005            __________________________________
  8. 408-336-8625                    __________________________________
  9. (8AM-9PM) PST
  10.                            Contact individual:
  11.  
  12.                                 __________________________________
  13.                                 __________________________________
  14.  
  15.                            Purchase Order Number (if applicable):
  16.  
  17.                                 __________________________________
  18.  
  19. Personal Registration
  20.  
  21. Qty                                        Unit Price        Total
  22.  
  23. ___    AutoChek v.2.0           X            $5.00           _____
  24.  
  25.  
  26. Business Registration
  27.  
  28. Qty
  29.  
  30.       One computer              X            $5.00           _____
  31.  
  32. ___   Additional Computers      X            $1.00           _____
  33.  
  34.  
  35.  
  36.                                             Grand Total      _____
  37.  
  38. California sales tax is included in the above listed prices.
  39.  
  40. Disk type selection:  5 1/4" ______   3 1/2" ______
  41.  
  42.                      Thank you for your support!