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REGISTER.DOC
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1992-03-30
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MQM V1.00
REGISTRATION FORM
-----------------
(Please Print)
Registered to: _______________________________________
First Name : ____________________________ Last Name: ______________ MI: ___
Address: _________________ City: ___________ State: ___ Postal Code:_______
Country: __________________ Home Phone: ( ### ) ###-####
Business : ( ### ) ###-####
WHAT SIZE DISK DO YOU WANT THE PROGRAM SENT ON?: 3½ or 5¼
(Please circle one)
USA or CANADA FOREIGN
~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~
MQM : $ 15.00 MQM : $ 20.00
Ontario Residents
please add 15%
sales tax : $
TOTAL : $ TOTAL : $______
Please specify if you wish to download MQM upon recipt of your order from
our support BBS:
Valhalla BBS (519) 433-5122 (8N1 - 9600 v.32/v.42BIS, MNP 2-5) (ATI etc/e)
PAYMENT BY CHECK OR MONEYORDER:
Make out a check or money order in Canadian funds for the total and
mail it with this form to the following address:
Matt Duƒresné
336 Highview Avenue East,
London, Ontario
CANADA
N6C 5G8