home *** CD-ROM | disk | FTP | other *** search
/ Collection of Tools & Utilities / Collection of Tools and Utilities.iso / batchut / dateinfo.zip / DI_ORDER.FRM < prev    next >
Text File  |  1993-05-09  |  1KB  |  49 lines
  1.  
  2.  
  3.                                 ARAD Software
  4.                              5011 Fletcher Place
  5.                            Rockford, IL 61108-4171
  6.                                      USA
  7.  
  8.  
  9. +----------------------------------------------------------------------------+
  10. |   Date Infominder v1.1                                 Registration Form   |
  11. +----------------------------------------------------------------------------+
  12.  
  13.  
  14.  
  15. Name (last,first):    _______________________________________________________
  16.  
  17.  
  18. Street Address:       _______________________________________________________
  19.  
  20.  
  21. City, State, Zip      _______________________________________________________
  22.  
  23.  
  24. Country (if not USA)  _______________________________________________________
  25.  
  26.  
  27.  
  28.  
  29.        Single program registration fee $15                   $15.00
  30.        
  31.        Latest version & Printed Manual
  32.             U.S. $5, Foreign orders $10                      ______
  33.  
  34.  
  35.        Total (Payment in US Currency only)                   ______
  36.  
  37.  
  38.        
  39.        Disk Type:  3 1/2" [  ]     HD [  ]   DD [  ]          
  40.                    5 1/4" [  ]     HD [  ]   DD [  ]
  41.  
  42.  
  43.        *** Make checks payable to BRIAN GUGLIEMETTI ***
  44.  
  45.         Mail to:      Brian Gugliemetti
  46.                       c/o ARAD Software
  47.                       5011 Fletcher Place
  48.                       Rockford, IL 61108-4171
  49.