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Text File  |  1996-12-08  |  2KB  |  53 lines
  1. Software Registration Form
  2. ____________________________________________________________________
  3. Name:
  4. [1]
  5. [2]
  6. [3]
  7. Phone/FAX:   [4]       [5]
  8.  
  9. Email:   [6]
  10.  
  11. Comments:   [7]  
  12.  
  13. Payment Method:
  14. [8]
  15. [9]
  16. [10]
  17. [11]
  18.  
  19. Signature (when sending via standard mail):___________________________________
  20.  
  21. Products Ordered:
  22. ([12]) TakeABreak 2.0 ($10 each).................:   [13]
  23. ([14]) QuickScrap ($15 each)........................:   [15]
  24. ([16]) ScrapIt Pro ($20 each).......................:   [17]
  25. ([18]) QuickScrap & ScrapIt Pro ($30 each):   [19]
  26. ([20]) QuickPop ($10 each)...........................:   [21]
  27. ([22]) ViewFont ($5 each)..............................:   [23]
  28. ([24]) ColorFall ($10 each)...........................:   [25]
  29. ([26]) Escape! ($10 each)..............................:   [27]
  30. ([28]) SideMinder ($10 each)........................:   [29]
  31.  
  32. Quantity Discount...........:   [30]
  33. Send Latest?...(adds $5):   [31]
  34. Disk Size (800k or HD):   [32]
  35. Sales Tax (CA Only).......:   [33]
  36. Note: Sales Tax is only collected if you've requested a disk and you live in California
  37.  
  38. Total Due.........................:   [34]
  39.  
  40. [35]
  41. ____________________________________________________________________
  42. FAX, send via stail or email this registration form to:
  43.  
  44. John V. Holder                                                           Email addresses (AOL is preferred):
  45. 1734 "S" Street                                                         America Online:  JohnHolder
  46. Eureka, CA  95501                                                    Internet...........:  JohnHolder@aol.com
  47. USA                                                                            CompuServe....:  75040,1126
  48.  
  49. FAX:  (707) 443-3813
  50.  
  51. Home Page:   http://www.northcoast.com/~jvholder
  52. (check for the latest new releases and updates!)
  53.