home *** CD-ROM | disk | FTP | other *** search
/ Wonders of the Modern World / MODERN.iso / pc / register.txt < prev    next >
Text File  |  2000-06-16  |  2KB  |  50 lines
  1. Product Registration  (MAR490-1, Wonders of the Modern World)
  2.  
  3. Return this form to receive upgrades, discounts and new product information. Mail to: 
  4. Arc Media Inc., 5330 Main Street #210, Buffalo, NY 14221-5360, fax to: (416) 410-9651 
  5. or register on our web site: www.arcmedia.com
  6.  
  7. Name: _______________________________________________________________________________
  8.  
  9. Age: ____________  Occupation: ______________________________________________________
  10.  
  11. Street:  ____________________________________________________________________________
  12.  
  13. City: ____________________________________________  State: __________________________
  14.  
  15. Country: _________________________________  ZIP/Postal Code: ________________________
  16.  
  17. Telephone: ___________________________  Fax: ________________________________________
  18.  
  19. E-mail: _____________________________________________________________________________
  20.  
  21. Platform:    [  ] Macintosh   [  ] Windows 95   [  ] Windows 98   [  ] Windows NT
  22.  
  23. Please rate this product:    [  ] Excellent    [  ] Good    [  ] Poor
  24.  
  25. Comments: ___________________________________________________________________________
  26.  
  27. _____________________________________________________________________________________
  28.  
  29. _____________________________________________________________________________________
  30.  
  31. ORDER FORM:
  32.  
  33. Title Name                         Part #            Qty
  34.  
  35. 1________________________________________________    ___________________    _________
  36.  
  37. 2________________________________________________    ___________________    _________
  38.  
  39. 3________________________________________________    ___________________    _________
  40.  
  41. Order Paid by: [ ] Check  [ ] Money Order  [ ] MasterCard  [ ] Visa   [ ] Amex
  42.  
  43.     Credit Card #: _______________________  Name: _______________________________
  44.     
  45.     Expiry Date: _____________________  Signature: ______________________________
  46.  
  47. Please make check or money order payable to ARC MEDIA INC.
  48.  
  49. [ ] Please send me a free catalog
  50.