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Text File  |  1993-05-20  |  1KB  |  44 lines
  1.                             REGISTRATION FORM
  2.  
  3.                             Gem Mania  v. 1.0
  4.  
  5.             Please Register me as a satisfied user of Gems:
  6.  
  7.  
  8.  
  9.  
  10.  
  11.           NAME:  ______________________________________________________
  12.  
  13.           STREET:______________________________________________________
  14.  
  15.           CITY:  ______________________________________________________
  16.  
  17.           STATE: ___________________________________ZIP________________
  18.  
  19.           TELEPHONE: __________________________________________________
  20.  
  21.           COMMENTS: ___________________________________________________
  22.  
  23.           _____________________________________________________________
  24.  
  25.           _____________________________________________________________
  26.  
  27.           _____________________________________________________________
  28.  
  29.           _____________________________________________________________
  30.  
  31.  
  32.    Send solution sheet:  [ ] Yes    [ ] No
  33.  
  34.    Specify distribution medium (check one):  [ ] 3╜"  [ ] 5╝"
  35.    (add $1.00 shipping and handling)
  36.  
  37.    Make checks payable to: Homespun Software
  38.  
  39.    Mail to:
  40.  
  41.     Homespun Software
  42.     162 Whitney St.
  43.     Northborough, MA 01532
  44.