home *** CD-ROM | disk | FTP | other *** search
/ Share Gallery 1 / share_gal_1.zip / share_gal_1 / UT / UT057.ZIP / REGISTER.FRM < prev    next >
Text File  |  1989-10-30  |  2KB  |  60 lines

  1.  
  2.  
  3.                       Registration Form for JADU v1.3
  4.  
  5.  
  6.  
  7.  
  8.      Name:           ___________________________________________________
  9.  
  10.      Company:           ___________________________________________________
  11.  
  12.      Address:          ___________________________________________________
  13.  
  14.      City, State, Zip: ___________________________________________________
  15.  
  16.      Country:          ___________________________________________________
  17.  
  18.      Phone number:     (_____)______-________
  19.  
  20.      Today's date:     ___/___/___
  21.  
  22.      Do you require a 3 1/2" disk?   Yes / No
  23.      
  24.      
  25.      Where did you find out about JADU? __________________________________
  26.  
  27.                   ________________________________________________________
  28.  
  29.                   ________________________________________________________
  30.  
  31.                   ________________________________________________________
  32.                   
  33.                   
  34.      Comments:      ________________________________________________________
  35.  
  36.                   ________________________________________________________
  37.  
  38.                   ________________________________________________________
  39.  
  40.                   ________________________________________________________
  41.  
  42.  
  43.  
  44.      Mail $25 (check or money order) to:
  45.  
  46.  
  47.                            J.C. Ratjen
  48.                            2126 Glebe Avenue
  49.                            New York, NY 10462
  50.  
  51.  
  52.  
  53.      Funds must be drawn on a U.S. bank.  Overseas registrants please
  54.      add $3 to cover shipping.
  55.      
  56.  
  57.  
  58.      Site licenses and customized versions available.  Read SITE.DOC 
  59.      or call (212)823-1050 for additional information.
  60.