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Text File  |  1992-09-17  |  2.5 KB  |  59 lines
  1. ANSIPLUS Version 2.04           Registration Form         September 1992
  2.  
  3. Required Information
  4. ====================
  5.  
  6.                      Your Name: ________________________________________
  7.  
  8.                   Company Name: ________________________________________
  9.  
  10. Registered Name (if different): ________________________________________
  11.  
  12.                Mailing Address: ________________________________________
  13.  
  14.                                 ________________________________________
  15.  
  16.                           City: ________________________________________
  17.  
  18.                 State/Province: __________  Zip/postal zone: ___________
  19.  
  20.          Country (if not U.S.): ________________________________________
  21.  
  22.               Telephone Number: ____________________________
  23.  
  24.         Media type (check one):  3.5" DD_____  5.25" HD_____
  25.  
  26.   Number of copies ordered: __________ Include printed manual (Y/N)?____
  27.                                       
  28. Price per copy (see table): __________                Each      Each
  29.                                           Quantity  w/Manual  Disk Only
  30.  Subtotal (price X copies): __________    --------  --------  ---------
  31.  
  32.                  Sales tax: __________        1      $39.00    $25.00
  33.                                               2       35.00     22.00
  34.     Shipping ($2.00 outside                   3       32.00     20.00
  35.      U.S. and Canada only): __________        4       30.00     19.00
  36.                                               5       28.00     18.00
  37.                      Total:
  38.                             ==========      Call for quantity, corporate
  39.                                             and site license pricing
  40. Please remit check or money order
  41. payable in U.S. dollars only.
  42.                                             Mail to:  Kristofer Sweger
  43.                                                       P.O. Box 378
  44. Optional Information                                  Larkspur, CA 94977
  45. ====================                                  (415) 924-5407
  46.  
  47. How did you hear about ANSIPLUS? _______________________________________
  48.  
  49. Type of computer: ______________________  DOS version: _________________
  50.  
  51. Video controller: ______________________  Type of display: _____________
  52.  
  53. Comments: ______________________________________________________________
  54.  
  55. ________________________________________________________________________
  56.  
  57. ________________________________________________________________________
  58.  
  59.