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  1. Registration Form
  2.  
  3.  
  4. Quantity ________  x $ 15.00    =           $  ________
  5.  
  6. Shipping (U.S. $4.00, Canada and
  7.   Mexico $6.00, foreign $8.00)              $  ________
  8.  
  9. Missouri Residents please add 6% sales tax  $  ________
  10.  
  11. Total                                       $  ________
  12.  
  13. Please include a Check or Money Order made payable to
  14. Kelly Schrock.
  15.  
  16.  
  17.  
  18.           Diskette size: [  ] 3.5"   [  ] 5.25"
  19.  
  20.  Name     _______________________________________________
  21.  Company  _______________________________________________
  22.  Address  _______________________________________________
  23.           _______________________________________________
  24.           _______________________________________________
  25.  Phone    _______________________________________________
  26.  
  27. I have read and agree to abide by the license agreement:
  28.  
  29.  Signature  _____________________________________________
  30.  
  31.  
  32. Where did you get System Notebook?
  33.  
  34.  ___________________________
  35.  
  36. If you received System Notebook from a BBS, what is
  37. its complete name and phone number?
  38.  
  39. ___________________________________
  40. _________________________________________________________
  41.  
  42. Please include any comments or suggestions on the lines
  43. which follow.  Use an additional page if necessary.
  44. _________________________________________________________
  45. _________________________________________________________
  46. _________________________________________________________
  47. _________________________________________________________
  48. _________________________________________________________
  49. _________________________________________________________
  50. _________________________________________________________
  51. _________________________________________________________
  52.  
  53. For information about volume discounts, site  licenses, and
  54. technical questions please contact VacNat Software.
  55.  
  56. Mail this form to:  VacNat Software
  57.                     1370 White Oak St.
  58.                     Harrisonville, MO 64701
  59.