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RegisterForm
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1996-09-27
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2KB
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74 lines
## ## ####### ####### ##
## ## ## ## ##
#### ####### ###### ##
## ## ##
## ####### ####### ## Please send me a keyfile for XTrace !
-----------------------------------------------------------------------
Name : ____________________________________________________
Address : ____________________________________________________
____________________________________________________
____________________________________________________
Country : ____________________________________________________
Nearest big city : ____________________________________________________
Phone : ____________________________________________________
e-mail : ____________________________________________________
Hardware : ____________________________________________________
Payment by: [ ] Eurocheque / Cheque for DM 30.00
- don't forget to write your card number on the back of
the cheque
- make sure, that non-Eurocheques are drawn on a
german bank !
[ ] Money transfer of DM 30.00 to this account:
- bank: Sparkasse Leipzig, Leipzig, Germany
- bank code: 860 555 92
- account number: 1823660556
[ ] Cash
[ ] UK£ 15.00 (UK pound)
[ ] US$ 25.00 (US dollar)
[ ] DM 30.00 (Deutsche Mark)
Delivery: [ ] by mail on a branded 3.5" disk
[ ] keyfile e-mailed uuencoded to you
I have read the distribution conditions and accept these. I install the
keyfile only on my Amiga and don't copy this one to thirds.
____________________ _______________________________________
date signature
Thank you for registering XTrace !
I will send you your keyfile when I have received the cheque/money.
-----------------------------------------------------------------------
Ronny Schütz e-mail: rschuet@imn.htwk-leipzig.de
Lene-Voigt-Strasse 8/304 WWW : http://www.imn.htwk-leipzig.de/~rschuet
04289 Leipzig
Germany