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Text File  |  1995-02-11  |  2KB  |  59 lines
  1.  
  2.  
  3.     MOZART.SYS registration form                                    R007
  4.     ============================
  5.  
  6.  
  7.     +---------------------------------------------+
  8.     !                                             !
  9.     !                                             !
  10.     !                                             !
  11.     !                                             !
  12.     !         Robert Muchsel                      !    VAT No/TVA:
  13.     !         Hegaublick 2                        !    DE142280494
  14.     !         D - 78465 Konstanz                  !
  15.     !                                             !
  16.     !         Germany                             !    FAX:
  17.     !                                             !    +49-7533-3151
  18.     !                                             !
  19.     +---------------------------------------------+
  20.  
  21.     Name/Company:        ______________________________________
  22.  
  23.     Address:             ______________________________________
  24.  
  25.                          ______________________________________
  26.  
  27.     Country:             ______________________________________
  28.  
  29.     Telephone:           ________________ Fax: ________________
  30.  
  31.     e-Mail:              ______________________________________
  32.  
  33.     # Copies                                                      Amount
  34.  
  35.     ___ MOZART.SYS OS/2 Driver Registration (DM 20.-/US$ 12.50)   ______
  36.  
  37.     ___ (optional) Diskette (Europe: DM 5.-/US$ 3.20, other
  38.                              countries: DM 11.-/US$ 6.50)         ______
  39.  
  40.     Additional contributions ----------------------------------   ______
  41.  
  42.     NB: DM=Deutsche Mark                                        ==========
  43.  
  44.     Payment enclosed:
  45.  
  46.     ( ) Postal money order
  47.     ( ) EUROcheque # _____________ (in DM only please!)
  48.     ( ) (other) Check # _________________
  49.     ( ) Cash (German, Swiss, French, Austrian, and US currency)
  50.  
  51.     Please allow a maximum of 5 weeks for diskette delivery.
  52.  
  53.     Date/Signature: _________________________________________________________
  54.  
  55.  
  56.     Sound card used: ________________________________________________________
  57.  
  58.     Suggestions/Comments: Please use the back of this sheet.
  59.