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  1. Four Palms Royalty Free Digital Video
  2.  
  3. Registration Card
  4.  
  5. Thank you for purchasing Four Palms Royalty Free Digital Video.  To assure your customer support and to be on our mailing list for future releases, please complete and mail or fax this form to:
  6.  
  7. Four Palms, Inc.
  8. 11260 Roger Bacon Drive
  9. Suite 502
  10. Reston, VA 20190 
  11.  
  12. fax number:
  13. 703-834-0219
  14.  
  15.                                                                                                                                                                
  16. ________________________________________
  17. Name
  18.  
  19.  
  20. ________________________________________
  21. Title
  22.  
  23.  
  24. ________________________________________ 
  25. Company
  26.  
  27.  
  28. _________________________________________
  29. Address
  30.  
  31.  
  32. _________________________________________
  33. City                               State                    Postal Cod              Country
  34.  
  35.  
  36. _________________________________________
  37. Phone Number
  38.  
  39.  
  40. _________________________________________
  41. Fax Number
  42.  
  43.  
  44. _________________________________________
  45. Serial Number(s)
  46.  
  47.  
  48. __________________________________________
  49. Name of Product Purchased
  50.  
  51.  
  52. ___________________________________________
  53. Purchased From
  54.  
  55. Thank you,
  56.  
  57. Four Palms, Inc
  58.