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Text File  |  1993-10-22  |  2.0 KB  |  63 lines
  1.  
  2.  
  3.                     Software Products Order/Registration Form
  4.  
  5.     SciTech Software                            Date: (dd/mm/yy) ___/___/___
  6.     G.P.O Box 4216NN
  7.     Melbourne Victoria 3001                      ** Please read PRODUCTS.DOC
  8.     AUSTRALIA                                       for ordering information
  9.  
  10.     Name: __________________________________________________________________
  11.     Company: _______________________________________________________________
  12.     Address: _______________________________________________________________
  13.              _______________________________________________________________
  14.              _______________________________________________________________
  15.     Phone: _______________________  Fax: _________________________
  16.  
  17.     Register product(s) to: [ ] Company     [ ] Individual
  18.  
  19.     Computer: [ ] 386 PC [ ] 486 PC [ ] Pentium PC [ ] Macintosh
  20.               [ ] Other (please specify) ___________________________________
  21.  
  22.     OS:       [ ] MSDOS  [ ] OS/2   [ ] Windows NT [ ] Unix
  23.               [ ] Other (please specify) ___________________________________
  24.  
  25.     Pay By:   [ ] Cheque  [ ] Money Order
  26.  
  27.     SC Product (see PRODUCTS.DOC for details) Cost per unit  Qty    Price
  28.        -------------------------------------- -------------  ---    ------
  29.     A  Universal VESA VBE                     US$15 (A$20)   ___  $ ______
  30.     A  Universal VESA VBE Source Code         US$50 (A$75)   ___  $ ______
  31.     A  Miscellaneous freeware                 US$15 (A$20)   ___  $ ______
  32.  
  33.         Disk size:   [ ] 3.5"     [ ] 5.25"
  34.  
  35.     Subtotal:                                                     $ ______
  36.     Shipping Charges (see PRODUCTS.DOC for amount!):              $ ______
  37.     Total Enclosed:                                               $ ______
  38.  
  39.     I have read and agree to abide by the enclosed license agreement:
  40.  
  41.       (Signature) _____________________________________________________
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  63.     Software Tools Order/Registration Form                      Page: 1