home *** CD-ROM | disk | FTP | other *** search
/ Software USA 3 #11 / Software USA Volume 3.11.iso / mac / LifeStyles / TakeABreak / Registration (open me!) / Registration (open me!).rsrc / TEXT_1132_Credit Card Order form (email).txt < prev    next >
Text File  |  1996-12-08  |  1KB  |  54 lines
  1. Software Registration Form
  2. ____________________________________________________________________
  3.  
  4. Name:
  5. [1]
  6. [2]
  7. [3]
  8. Phone/FAX:   [4]       [5]
  9.  
  10. Email:   [6]
  11.  
  12. Comments:   [7]  
  13.  
  14. Payment Method:
  15. [8]
  16. [9]
  17. [10]
  18. [11]
  19.  
  20. Products Ordered:
  21. ([12]) TakeABreak 2.0 ($10 each)..........:   [13]
  22. ([14]) QuickScrap ($15 each)..............:   [15]
  23. ([16]) ScrapIt Pro ($20 each).............:   [17]
  24. ([18]) QuickScrap & ScrapIt Pro ($30 each):   [19]
  25. ([20]) QuickPop ($10 each)................:   [21]
  26. ([22]) ViewFont ($5 each).................:   [23]
  27. ([24]) ColorFall ($10 each)...............:   [25]
  28. ([26]) Escape! ($10 each).................:   [27]
  29. ([28]) SideMinder ($10 each)..............:   [29]
  30.  
  31. Quantity Discount.......:   [30]
  32. Send Latest?...(adds $5):   [31]
  33. Disk Size (800k or HD)..:   [32]
  34. Sales Tax (CA Only).....:   [33]
  35. Note: Sales Tax is only
  36. collected if you've
  37. requested a disk and you
  38. live in California
  39.  
  40. Total Due.........................:   [34]
  41.  
  42. [35]
  43. ____________________________________________________________________
  44. Email this registration form to:
  45.  
  46. John V. Holder                   Email addresses (AOL is preferred):
  47. 1734 "S" Street                  America Online:  JohnHolder
  48. Eureka, CA  95501                Internet......:  JohnHolder@aol.com
  49.                                  CompuServe....:  75040,1126
  50. FAX:  (707) 443-3813
  51.  
  52. Home Page:   http://www.northcoast.com/~jvholder
  53. (check for the latest new releases and updates!)
  54.