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  1.  ┌────────────────────────────────────────────────────────────────────────────┐
  2.  │                  OnScreen/2 2.11 Registration - USA ONLY                   │
  3.  │                                                                            │
  4.  │ Name    __________________________________________________________________ │
  5.  │ Company __________________________________________________________________ │
  6.  │ Address __________________________________________________________________ │
  7.  │         __________________________________________________________________ │
  8.  │ Phone   _____________________________  Fax _______________________________ │
  9.  │                                                                            │
  10.  │ Register OnScreen/2 to:   [ ] Company     [ ] Individual                   │
  11.  │                                                                            │
  12.  │ Where did you download/receive OnScreen/2 from ___________________________ │
  13.  │                                                                            │
  14.  │ Where did you hear about OnScreen/2 ? ____________________________________ │
  15.  │                                                                            │
  16.  │ Your E-Mail address (if any)    __________________________________________ │
  17.  │                                                                            │
  18.  │ Update notification via E-Mail   [ ]                                       │
  19.  │                                                                            │
  20.  │  PRODUCT                            PRICE   NUMBER OF COPIES        VALUE  │
  21.  │                                                                            │
  22.  │  OnScreen/2 for OS/2               $20.00   * ________ =     + $ ________  │
  23.  │  OnScreen/2 for DOS                $20.00   * ________ =     + $ ________  │
  24.  │  OnScreen/2 for Win32              $20.00   * ________ =     + $ ________  │
  25.  │  OnScreen/2 for OS/2 & DOS         $30.00   * ________ =     + $ ________  │
  26.  │  OnScreen/2 for OS/2 & Win32       $30.00   * ________ =     + $ ________  │
  27.  │  OnScreen/2 for Win32 & DOS        $30.00   * ________ =     + $ ________  │
  28.  │  OnScreen/2 for OS/2, DOS & Win32  $35.00   * ________ =     + $ ________  │
  29.  │                                                                            │
  30.  │  BELOW ARE OUR SHIPPING CHARGES IF WE SHIP PACKAGES OR PRIORITY            │
  31.  │                                                                            │
  32.  │    Worldwide 1st Class .........................    Free                   │
  33.  │    2nd Day Priority, USA Only .................. $  4.00 US   + $ ________ │
  34.  │    US Postal Service International Express                                 │
  35.  │      (Including Canada and Mexico), allow up to                            │
  36.  │      7-10 days ................................. $ 15.00 US   + $ ________ │
  37.  │    FedEx OVernight, USA Only (delivery by                                  │
  38.  │      3:00pm the following day) ................. $ 15.00 US   + $ ________ │
  39.  │                                                                            │
  40.  │  Total:                                                         $ ________ │
  41.  │                                                                            │
  42.  └────────────────────────────────────────────────────────────────────────────┘
  43.  ┌────────────────────────────────────────────────────────────────────────────┐
  44.  │                               PAYMENT METHOD                               │
  45.  │ Check one                                                                  │
  46.  │  [ ] Cash                                                                  │
  47.  │  [ ] Cheque/Money order                                                    │
  48.  │                                                                            │
  49.  │ Please make cheques payable to BMT Micro. If sending cash please use       │
  50.  │ registered post.                                                           │
  51.  │                                                                            │
  52.  │                          CREDIT CARD PAYMENT ONLY                          │
  53.  │ Check one                                                                  │
  54.  │  [ ] Visa                                                                  │
  55.  │  [ ] Mastercard                                                            │
  56.  │  [ ] Discover                                                              │
  57.  │  [ ] American Express                                                      │
  58.  │                                                                            │
  59.  │  Credit card number:      _________________________________________        │
  60.  │                                                                            │
  61.  │  Expiration date:         ______________________                           │
  62.  │                                                                            │
  63.  │  Authorization signature: ______________________                           │
  64.  │                                                                            │
  65.  └────────────────────────────────────────────────────────────────────────────┘
  66.  ┌────────────────────────────────────────────────────────────────────────────┐
  67.  │                  CHECKING OR SAVINGS ACCOUNT PAYMENT ONLY                  │
  68.  │                             USA CUSTOMERS ONLY                             │
  69.  │                                                                            │
  70.  │ Registration can also be done by  phone  with  your  checking  or  savings │
  71.  │ account  (including  bank  money  market  and NOW accounts) This method of │
  72.  │ registration requires no more information that what is probably already on │
  73.  │ your check and will not only save  you from waiting on the mail to deliver │
  74.  │ your check but also speed up delivery of  your  order.   When  registering │
  75.  │ using this method, our normal policy regarding check clearance applies (we │
  76.  │ actually  get  a  check  drawn  on your account from our banking service - │
  77.  │ there are no electronic transfers that affect your checking account.) This │
  78.  │ is EXACTLY like registering by  check  but  you  don't have to wait on the │
  79.  │ postal service to deliver your check.                                      │
  80.  │                                                                            │
  81.  │ NOTE: This service cannot be used if 2 signatures are required on the      │
  82.  │       account.                                                             │
  83.  │                                                                            │
  84.  │ Have this information ready when you choose this method  of  registration. │
  85.  │ If you are faxing your registration and using this method, don't forget to │
  86.  │ fax this information also.                                                 │
  87.  │                                                                            │
  88.  │ Name on account _____________________________________________________      │
  89.  │                                                                            │
  90.  │ Complete Address ____________________________________________________      │
  91.  │                                                                            │
  92.  │ City ________________________________________________________________      │
  93.  │                                                                            │
  94.  │ State ________________________________________                             │
  95.  │                                                                            │
  96.  │ Zip Code _____________________________________                             │
  97.  │                                                                            │
  98.  │ Home Phone Number ____________________________                             │
  99.  │                                                                            │
  100.  │ Work Phone Number ____________________________                             │
  101.  │                                                                            │
  102.  │ Type of Account ______________________________  (checking or savings)      │
  103.  │                                                                            │
  104.  │ Check Number _________________________________                             │
  105.  │                                                                            │
  106.  │ Bank Routing Number __________________________                             │
  107.  │                                                                            │
  108.  │ Bank Account Number __________________________                             │
  109.  │                                                                            │
  110.  │ Amount of Check ______________________________                             │
  111.  │                                                                            │
  112.  │ Driver License Number ________________________                             │
  113.  │                                                                            │
  114.  │ You may also fax a check made out to us for your registration.  From       │
  115.  │ the fax we can get all the info we need to process your draft.  Be         │
  116.  │ sure add a line to the fax that says "ordered by fax" and your             │
  117.  │ signature.                                                                 │
  118.  └────────────────────────────────────────────────────────────────────────────┘
  119.  ┌────────────────────────────────────────────────────────────────────────────┐
  120.  │                               ORDERING MENU                                │
  121.  │                                                                            │
  122.  │            Via Surface Mail: BMT Micro                                     │
  123.  │                              452 Horn Road                                 │
  124.  │                              Wilmington, NC 28412-2411                     │
  125.  │                              U.S.A.                                        │
  126.  │                                                                            │
  127.  │                       Voice: 8:00am - 8:00pm EST (-5 GMT)                  │
  128.  │                              (800) 414-4268  (Orders only)                 │
  129.  │                              (910) 791-7052  (Orders, questions)           │
  130.  │                                                                            │
  131.  │                         Fax: (910) 350-2937  24 hours / 7 days             │
  132.  │                                                                            │
  133.  │                      Online: (910) 350-8061  10 lines, all 14.4k           │
  134.  │                              (910) 799-0923  Direct 28.8k line             │
  135.  │                                                                            │
  136.  │         Via Electronic mail:                                               │
  137.  │                  Compuserve: Thomas Bradford, 74031,307                    │
  138.  │                    Internet: thomas.bradford@bmtmicro.com                  │
  139.  │                                                                            │
  140.  │           Fidonet questions: Thomas Bradford, 1:3628/11                    │
  141.  │ Technical support questions: Internet jallen@iol.ie (John Allen, author)   │
  142.  │                                                                            │
  143.  │ We accept Visa, Mastercard, Discover, American Express, Money Order,       │
  144.  │ Cashiers Check, Personal Check. Please do not send cash in the mail.       │
  145.  │ Personal checks are subject to clearance.                                  │
  146.  └────────────────────────────────────────────────────────────────────────────┘
  147.  ┌────────────────────────────────────────────────────────────────────────────┐
  148.  │                             DISCOUNT STRUCTURE                             │
  149.  │                                                                            │
  150.  │ Qty     Percentage discount                                                │
  151.  │ 2-5     5%.                                                                │
  152.  │ 6-10    6%.                                                                │
  153.  │ 11-20   8%.                                                                │
  154.  │ 20-100  10%.                                                               │
  155.  │ 100+    please call or email                                               │
  156.  │                                                                            │
  157.  └────────────────────────────────────────────────────────────────────────────┘
  158.  ┌────────────────────────────────────────────────────────────────────────────┐
  159.  │                     Additional information (optional)                      │
  160.  │                  Which is your working environment like?                   │
  161.  │                                                                            │
  162.  │   Operating System                            Hardware spec                │
  163.  │ OS/2 1.x         [ ]            __________________________________________ │
  164.  │ OS/2 2.x         [ ]            __________________________________________ │
  165.  │ OS/2 Warp 3.0    [ ]            __________________________________________ │
  166.  │ Windows 3.x      [ ]            __________________________________________ │
  167.  │ Windows NT 3.1   [ ]            __________________________________________ │
  168.  │ Windows NT 3.5   [ ]            __________________________________________ │
  169.  │ DOS              [ ]            __________________________________________ │
  170.  │ Linux            [ ]            __________________________________________ │
  171.  │ FreeBSD          [ ]            __________________________________________ │
  172.  │ Macintosh        [ ]            __________________________________________ │
  173.  │ Other Unix       _____________  __________________________________________ │
  174.  │ Other            _____________  __________________________________________ │
  175.  │                                                                            │
  176.  │                                                                            │
  177.  │ This information will help me decide whether to port OnScreen/2 to         │
  178.  │ additional platforms.                                                      │
  179.  └────────────────────────────────────────────────────────────────────────────┘
  180.  
  181.  Thanks,
  182.  John J. Allen
  183.  
  184.