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Text File  |  1995-09-12  |  2KB  |  61 lines
  1. REQUEST FOR SUPPORT AND/OR REGISTRATION FOR "OS/2 Periodical Database"
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  3.  
  4.     Name:     _______________________________________________________________
  5.  
  6.     Company:  _______________________________________________________________
  7.  
  8.     Address:  _______________________________________________________________
  9.  
  10.     City:     ____________________________  State: ____  Zip code: __________
  11.  
  12.     (outside U.S.A.) Postal code: ________  Country:  _______________________
  13.  
  14.     Telephone numbers (optional):
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  16.          Day:  _________________________  Evening:  _________________________
  17.  
  18.     If response via e-mail is acceptable: CompuServe ID:  __________ , ______
  19.  
  20.         Internet ID: ________________________________________________________
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  23. Registration fee (if registering the database):
  24.  
  25.     OS/2 Periodical Data Base:
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  27.         ___ register current and future updates  $ 5 per user   $ ___________
  28.            (database is no longer shipped on disk due to size)
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  31. Additional Information (for comments or if requesting support):
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  51. _____________________________________________________________________________
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  53. _____________________________________________________________________________
  54.  
  55. Send this completed form to:
  56.  
  57.     Robert Simpson
  58.     2839 Dolores Drive
  59.     Library, PA  15129
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