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Text File  |  1993-09-19  |  1.4 KB  |  54 lines
  1.                         
  2.                         VIDMODE REGISTRATION FORM
  3.                         
  4.         
  5.         
  6.         Name ________________________________________
  7.         
  8.      Address ________________________________________
  9.         
  10.  City, State ________________________________________
  11.         
  12.          Zip ________
  13.          
  14.          
  15.          
  16.          
  17.     Comments ___________________________________________________
  18.     
  19.              ___________________________________________________
  20.              
  21.              ___________________________________________________
  22.              
  23.              ___________________________________________________
  24.              
  25.              ___________________________________________________
  26.              
  27.              
  28.              
  29.     Cost (Check One):  _____ $3.00 to Register
  30.     
  31.                        _____ $5.00 to Register and receive one upgrade
  32.                                    when it becomes available.
  33.                              
  34.                              3.5 _____    5.25 _____
  35.                              
  36.                              
  37.     Please send this form and a check or money order made out 
  38.     to Martha Decker for the appropriate amount to:
  39.     
  40.     
  41.     Martha Decker
  42.     
  43.     3005 W. 70-1/2 Street
  44.     
  45.     Richfield, MN 55423
  46.     
  47.     
  48.     Thank you for supporting my efforts!
  49.     
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  51.     
  52.     
  53.                  
  54.