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REGIS.FRM
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1996-10-07
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Please fill the form below and send it to PsL by
Email : CompuServe 71355,470 (INTERNET 71355.470@compuserve.com)
Send a message with the subject "BALLOONS REGISTRATION"
and the form below as the body of the message.
FAX: Send form to 713-524-6398
Mail: Print form and send to:
PsL
P.O. Box 35705
Houston, TX 77235,5705
USA
(Form begins below this dotted line)
...............................................................
REGISTRATION FORM
Product # 14886
Program name: BALLOONS
Author: Eugenio Garcia
**************************************************
Name:_________________________________________________________
Street address:_______________________________________________
______________________________________________________________
City:________________________ State (Province):_______________
ZIP Code:_______________ Country:_____________________
Credit Card: ( ) VISA; ( ) American Express
( ) Master Charge; ( ) Discover
Credit Card Number:________________________Expiration Date:_________
Signature______________________________________
**************************************************
Price of the Balloons program: $ 14.00
Shipping & Handling (worldwide): $ 5.00
...................
Cost including S&H $ 19.00
Quantity x ( 1 )
...................
Total Cost $ 19.00
Sales tax will be added for residents of Texas: 8.25%
Check disk size preferred: (X) 3.5" 1.44MB disk;
( ) 5.25" 1.2MB disk