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Text File  |  1996-07-28  |  2KB  |  57 lines
  1.                           WPC Registration Form
  2.  
  3.  
  4.    Name: _____________________________________________________________
  5.  
  6. Address: _____________________________________________________________
  7.  
  8.          _____________________________________________________________
  9.  
  10.          _____________________________________________________________
  11.  
  12.          _____________________________________________________________
  13.  
  14.   Email: _____________________________________________________________
  15.  
  16.  
  17. Payment Method: Check___    Money Order___    Visa___    Mastercard___
  18.  
  19. If ordering by check or money order they must be in US funds.
  20.  
  21. If ordering by credit card include the following information.
  22.  
  23.  
  24.       Bank Name: _____________________________________________________
  25.  
  26.    Name On Card: _____________________________________________________
  27.  
  28.     Card Number: _____________________________________________________
  29.  
  30. Expiration Date: _____________________________________________________
  31.  
  32.  
  33. Each registration allows you to install
  34. WPC on one computer.  Enter the number of
  35. registrations you are ordering.  Multiply
  36. this number by 20 dollars and enter the
  37. total dollar amount.                        _____ X $20.00 = ________
  38.  
  39. Your registration(s) will be emailed to
  40. you upon receiving the  registration fee.
  41. If you need the latest version of the
  42. software mailed to you please include 2
  43. dollars per registration for S & H.         _____ X $ 2.00 = ________
  44.  
  45.  
  46.                              Total from the above two lines: ________
  47.  
  48.  
  49. Send this form with payment or credit card information to:
  50.  
  51.                                 Steve Parker
  52.                                 3119 Porter Avenue
  53.                                 Kingsport, TN.  37663
  54.  
  55. Make all checks payable to Steve Parker
  56.  
  57.