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Text File  |  1991-07-07  |  4KB  |  64 lines
  1.  ______________________________________________________________
  2. |                                                              |
  3. |                  SOFTWARE REGISTRATION FORM                  |
  4. |______________________________________________________________|
  5. |                                                              |
  6. |                                                              |
  7. | NAME             __________________________________________  |
  8. |                                                              |
  9. | ADDRESS          __________________________________________  |
  10. |                                                              |
  11. |                  __________________________________________  |
  12. |                                                              |
  13. |                  __________________________________________  |
  14. |                                                              |
  15. |                                                              |
  16. | PHONE            __________________________________________  |
  17. |                                                              |
  18. |                                                              |
  19. | OFFICE SYMBOL    __________________________________________  |
  20. | or ROUTER                                                    |
  21. |                                                              |
  22. | POINT OF CONTACT __________________________________________  |
  23. | (organizations)                                              |
  24. |                                                              |
  25. | SIGNATURE & DATE __________________________________________  |
  26. |                                                              |
  27. |                                                              |
  28. | WHERE DID YOU                                                |
  29. | OBTAIN THIS      __________________________________________  |
  30. | SOFTWARE?                                                    |
  31. |                                                              |
  32. | COMMENTS OR      __________________________________________  |
  33. | SUGGESTIONS                                                  |
  34. | (continue on                                                 |
  35. |  reverse if      __________________________________________  |
  36. |  desired)                                                    |
  37. |______________________________________________________________|
  38. |                                                              |
  39. | PRODUCT                             | QTY | EACH  |  TOTAL   |
  40. |______________________________________________________________|
  41. |                                                  *           | 
  42. | Renamer/2, version 1.01             |     |  5.00 |          | 
  43. |______________________________________________________________| 
  44. |                                                              | 
  45. | Tax (Virginia residents add 4-1/2%)               |          | 
  46. |______________________________________________________________| 
  47. |                                                              | 
  48. | TOTAL                                             |          | 
  49. |______________________________________________________________| 
  50. |                                                              | 
  51. | Send check or           Richard W. Adams                     | 
  52. | money order in          104 Willow Oaks Boulevard            | 
  53. | U.S. dollars to:        Hampton, VA  23669-1528              | 
  54. |                         U.S.A. **                            | 
  55. |______________________________________________________________| 
  56.  
  57.  *Prices may change without notice.
  58.  
  59. **If this address is no longer valid, try contacting the author
  60.   through the Association of Shareware Professionals (545 Grover 
  61.   Road, Muskegon, MI 49442) or send a CompuServe mail message to 
  62.   76430,1071.
  63.  
  64.