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  1.                         UltraEdit Order Form
  2.                         --------------------
  3. If you find UltraEdit/UltraEdit-32 useful, and continue to use it you are
  4. required to register it. 
  5.  
  6. Registration can be by one of the following methods:
  7. 1)      Check/Postal Order
  8. 2)      Credit Card - MasterCard or Visa
  9. 3)      CompuServe Online registration
  10.         (GO SWREG, register ID 2662 (UltraEdit) or ID 4017 (UltraEdit-32)
  11. 4)      Cash.
  12. 5)      Purchase Order
  13.  
  14. To register send payment/order to:
  15.         Ian D. Mead
  16.         8209 Chestnut Hill Ct.
  17.         West Chester, OH 45069
  18.         USA
  19.  
  20. For Visa/MasterCard orders, you may send E-Mail to:
  21. 1) idm@iglou.com
  22. 2) CompuServe 71613,2654
  23. or you may order by FAX/Telephone by calling (513) 779 8549.
  24.  
  25. Please provide the following information:
  26.  
  27. Name_____________________________________Company____________________________
  28.  
  29. Address_____________________________________________________________________
  30.  
  31. Address_____________________________________________________________________
  32.  
  33. City___________________ State/Prov.______________Zip/Postal Code____________
  34.  
  35. Country_____________________________________________________________________
  36.  
  37. Phone Number__________________________ E-Mail_______________________________
  38.  
  39. Disk size       ____ 5 1/4"     ____ 3 1/2" (3 1/2" sent if not specified)
  40.  
  41. Where Did you get UltraEdit/UltraEdit-32 ?
  42.  
  43. __________________________________________________________________________
  44.  
  45. Please check,     ____ UltraEdit  ____ UltraEdit-32
  46.  
  47.  
  48. Number of Licenses      Per/Unit Cost           Total
  49.                           $30.00
  50.  
  51. (Please call for site licenses)
  52. Amount Enclosed                             __________
  53.  
  54. Payment Method:
  55.  
  56. ____ Check/Money Order ____ VISA ____ MasterCard  ____ Cash  ____ Other
  57.  
  58.  
  59. Credit Card #_______________________________________ Expiration Date__________
  60.  
  61.  
  62. Signature ___________________________________________
  63. (Only required for mail in and FAX credit card orders)
  64.  
  65. Thank you for registering UltraEdit/UltraEdit-32.