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  1. OtherMenu Registration Form
  2.  
  3. Name:        ________________________________
  4.  
  5. Company:   ________________________________
  6.  
  7. Address:    ________________________________
  8.  
  9.                   ________________________________
  10.  
  11.                   ________________________________
  12.  
  13. E-mail:       ________________________________
  14.  
  15.  
  16. Item                                                  Quantity       Unit Price       Total
  17.  
  18. OtherMenu registration                     ______         $10                 _____
  19.  
  20. disk with current version                                       $5                  _____
  21.  
  22. Shipping and handling (purchase orders only!)         $5                  _____
  23.  
  24. Total                                                                                             _____
  25.  
  26.  
  27. Payment method:    cash ___    check ___    money order ___    purchase order ___
  28.  
  29.  
  30. Mail to:
  31.                     James W. Walker
  32.                     3200 Heyward Street
  33.                     Columbia, SC  29205
  34.  
  35.  
  36.