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Text File  |  1992-03-08  |  4KB  |  62 lines
  1.                                                                                
  2.          NEWBIZ 1.0 REGISTRATION FORM                                          
  3.          ~~~~~~~~~~~~~~~~~~~~~~~~~~~~                                          
  4.          
  5.          Please send by First Class AIR MAIL or Fax to:          
  6.                                                                                
  7.          - CCI Ltd., P.O. Box 286, 6800 AG ARNHEM-NL, Holland, Europe          
  8.      (*) - Fax (+31) 20.676.37.06 (attn. Robert Trost)                    
  9.                                                                                
  10.          Please send me my Personal Code for NewBiz 1.0 by return of           
  11.          Air Mail or CompuServe, so that NewBiz will "know" me and I        
  12.          may use it without being bothered by Registration reminders,       
  13.          get FREE User Support and receive a FREE NewBiz Update as        
  14.          soon as it becomes available.
  15.                                                                                
  16.          Please check format of FREE Update disk:  __ 5.25  __ 3.5
  17.                                                                                
  18.          
  19.          FIRST name: ____________________ (10 characters maximum!)             
  20.                                                                                
  21.          LAST name: ___________________________                                
  22.                                                                                
  23.          Street address or P.O. Box: ________________________________          
  24.                                                                                
  25.          City: _________________________________   Zip: _____________          
  26.                                                                                
  27.          Country: ______________________________                               
  28.                                                                                
  29.          CompuServe ID if applicable: ________ , ______                        
  30.                                                                                
  31.          
  32.          I am herewith paying US $24.95 + US $5.05 for S&H of FREE 
  33.          NewBiz Update = US $30.- by:
  34.                                                                                
  35.          - Credit Card: MasterCard\Access\Eurocard\Visa\Amex\Diners            
  36.                                                                                
  37.            Card number: ________  ________  ________  ________  ____           
  38.                                                                                
  39.            Expiry date: _____ / _____                                          
  40.                                                                                
  41.            Name(s) on Card: ______________________________                     
  42.                                                                                
  43.                             ______________________________                     
  44.                                                                                
  45.                                                                                
  46.            Signature: ____________________________________                     
  47.                                                                                
  48.          - Cash US $30 (US $24.95 + US $5.05 for S&H of FREE NewBiz 
  49.            Update)            
  50.            
  51.          - Eurocheque, written out to CCI Ltd. in Arnhem, Holland,
  52.            and in Hfls. 60 (Hfls. 50 + Hfls. 10 for S&H of Update)
  53.          
  54.            Please note: 
  55.            Personal cheques, or Eurocheques written out in other
  56.            currency than Dutch Guilders, can NOT be accepted!
  57.          
  58.      (*) When sending this Registration Form by Fax please don't
  59.          forget to complete the required Credit Card information!
  60.  
  61.  
  62.