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Text File  |  1996-09-23  |  1.1 KB  |  42 lines
  1.  
  2. Name or Company ...................................................
  3.  
  4. Address         ...................................................
  5.  
  6.                 ...................................................
  7.  
  8. State           ...................................................
  9.  
  10. Zip             ...................................................
  11.  
  12. Country         ...................................................
  13.  
  14. Program and version, 5x86..........................................
  15.  
  16. E-Mail address  ...................................................
  17.  
  18. Wish to register ....... copies of 5x86 at USD 15.00 each.
  19.  
  20. Payment of ......... is included.
  21.  
  22.  
  23. ---------------------------------------------------------------------
  24. Cut here
  25.  
  26. Cheque or bank transfer preferred.
  27.  
  28. Direct transfer:
  29.  
  30. Bankers           Standard Bank of South Africa
  31. Branch              Pietermaritzburg, Church St. East
  32. Account Name      P. N. Moss
  33. Account Number    058407219
  34.  
  35. Mail to: P N Moss
  36.          P O Box 212144
  37.          Oribi
  38.          Pietermaritzburg
  39.          Rep of South Africa, 3205
  40.  
  41. E-Mail: pmoss@yoda.alt.za
  42.