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Text File  |  1995-03-15  |  2.5 KB  |  56 lines
  1.                      REGISTRATION/ORDER FORM
  2.  
  3. To: ARK ANGLES            Phone: (047)588100 or Intl+61-47-588100
  4.     P O Box 190           Fax:   (047)588638 or Intl+61-47-588638
  5.     Hazelbrook NSW 2779   Internet:     100237.141@compuserve.com
  6.     AUSTRALIA             CompuServe:                  100237,141
  7.  
  8. or: INNOVATIVE THINKING   Phone: (047)592145 or Intl+61-47-592145
  9.     P O Box 47            Fax:   (047)592145 or Intl+61-47-592145
  10.     Lawson NSW 2783
  11.     AUSTRALIA
  12.  
  13. Name    _________________________________________________________
  14.  
  15. Company _________________________________________________________
  16.  
  17. Address _________________________________________________________
  18.  
  19. Town    __________________________  State ________  Code ________
  20.  
  21. Country _________________________________________________________
  22.  
  23. Phone   ___________________________  Fax ________________________
  24.  
  25. E-mail  _________________________________________________________
  26.  
  27. Where software seen or obtained _________________________________
  28. Computer:  [ ] XT    [ ] AT/286    [ ] 386    [ ] 486    [ ] >486
  29. Memory Size: ____________    Hard Disk Size: __________
  30. Drives: [ ] 5¼" 360K   [ ] 3½" 720K   [ ] 5¼" 1.2M   [ ] 3½" 1.4M
  31. Screen: [ ] Mono/Herc   [ ] CGA    [ ] EGA    [ ] VGA    [ ] >VGA
  32. Dos Ver# _________   Windows Ver# _________   OS/2 Ver# _________
  33.  ___________________________________________ _______ ___________
  34. | P R O D U C T  /  L I C E N S E           | Q T Y | P R I C E |
  35. |___________________________________________|_______|___________|
  36. |                                           |       |           |
  37. |___________________________________________|_______|___________|
  38. |                                           |       |           |
  39. |___________________________________________|_______|___________|
  40. |                                           |       |           |
  41. |___________________________________________|_______|___________|
  42. |                                           |       |           |
  43. |___________________________________________|_______|___________|
  44. | T O T A L                                         |           |
  45. |___________________________________________________|___________|
  46.  
  47. [ ] Bankcard   [ ] Mastercard   [ ] Visa   [ ] Cash/Cheque/Draft
  48.  
  49. Credit Card No  ______ ______ ______ ______   Expiry Date ___/___
  50.  
  51. Cardholder Name _________________________________________________
  52.  
  53. Signature       _____________________________   Date ____________
  54.  
  55. Comments:
  56.