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- Intellectual
- Inventions
- _____________________________________________________________________________
-
- U.S.A. and Canada - States and Provinces
- Intellectual Property Acknowledgement Licence Contribution Form
-
- By filling out this form, you will be granted the unlimited right to use
- U.S.A. and Canada - States and Provinces with an Intellectual Property
- Acknowledgement Licence registered under your name. Please fill out the
- following form and send it back with your IPALC to the address shown below.
- You contribution is crucial and will enable the creator of the program to
- develop other shareware programs in the future.
-
- All information given in this form will be kept strictly confidential unless
- otherwise stated.
-
- Please print or enter clearly.
-
-
- Name : _______________________________________________
-
- Company / Organization
- (if applicable) : _______________________________________________
-
-
- Address : _______________________________________________
- (Suite / Number / Street)
-
- _____________________ ________________
- City / Town State / Province
-
- _____________________ ________________
- Zip / Postal Code Country
-
-
- Phone : ________ ______________________
- Area Code Phone #
-
- Fax : ________ ______________________
- Area Code Fax #
-
- Do you wish your information to be kept confidential? [ ] Yes [ ] No
-
- Contribution Schedule
-
- [ ] Personal Licence <includes single-copy licence
- registered to one (1) individual> .. $ 5.00 x _______
-
- [ ] Site Licence <includes multiple-copy licence
- registered to multiple individuals
- at a single location>
-
- Site Licence Fee <first copy for EACH location> ...... $10.00 x _______
-
- Each additional copy ................................. $ 2.50 x _______
-
-
- Grand Total .......................................... $
- ================
-
- Please choose diskette size : [ ] 3.5" DD [ ] 5.25" DD
-
- Please send the completed form with the contribution in one of the follow-
- ing formats to the address below:
-
- (a) US or Canadian currency;
- (b) Cheque drawn in US or Canadian funds on a CANADIAN bank;
- (c) International Postal Money Order drawn in US or Canadian funds;
-
- Please make your contribution payable to Albert Hon.
-
- Currency Acceptance Policy
-
- All contributions will be accepted in either US or Canadian funds depending
- on your choice. However, cheques must be drawn on a CANADIAN bank.
-
- Please send to:
- Albert Hon
- 128 Holm Crescent
- Thornhill ON
- Canada L3T 5J3
-
- If you have any questions, please write to the address above or fax at
- (905)731-9570.
-
- END OF DOCUMENT : IPALC.DOC
-
- (C)1994 Albert K. Hon
- All Rights Reserved
-
- U.S.A. and Canada - States and Provinces is a member of the Intellectual
- Inventions family.
-
-