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  1. *****************************************************************
  2.                                                               MasterScan Product Registration Form
  3. *****************************************************************
  4.  
  5. Name that will appear in  program :    _______________________(30 chars MAX)
  6. (If you are ordering more than one copy please specify names for each copy.)
  7. (The name (company) is REQUIRED, and will be used for personalizing the program.)
  8.  
  9. Please ship the program(s) to:
  10.  
  11.             ___________________________.
  12.  
  13.             ___________________________.
  14.  
  15.             ___________________________.
  16.  
  17.             ___________________________  (foreign addresses add necessary postage $$)
  18.  
  19. I would like to order ___ copies of MasterScan at $12.50 each (includes U.S. post).
  20.  
  21. ----------------------------------------------------------------------------
  22. I would like to purchase a site license for:  ( please circle one )
  23.  
  24.                     #users                                 price
  25.                         -------------------------
  26.               3                          $35.00
  27.               4                            43.00
  28.               5                            50.00
  29.               6                            57.00    (inquire about educational rates)
  30.               7                            64.00    ( AOL:  JoeLaff                           )
  31.               8                            70.00    ( CIS:  70712,2306                    )
  32.               9                            75.00    (INTERNET:  joelaff@aol.com      )
  33.             10                            79.00 
  34.             11+          additional $4.00 per user
  35. ----------------------------------------------------------------------------
  36.  
  37.                                                                                                                             I am enclosing $_________ TOTAL
  38.  
  39. I would like to see this changed:  -OR-  I would like to see a program that does this:
  40. _________________________________________________________________.
  41. _________________________________________________________________.
  42. _________________________________________________________________.
  43. _________________________________________________________________.
  44.  
  45.  
  46. Please make checks payable to:
  47.         Joseph Laffey
  48.         15 Benton Place
  49.         St. Louis, MO 63104-2411
  50.