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Text File  |  1992-07-23  |  3KB  |  59 lines
  1.                    ================================
  2.                     ROBOCOMM 4.2 REGISTRATION FORM
  3.                    ================================
  4.  
  5.       -> Ordering from the U.K.?  Please use the UK-ORDER.FRM file! <-
  6.  
  7.  
  8.                     Remit to:  Parsons Consulting
  9.                                5020 S. Lake Shore Drive
  10.                                Suite 3301
  11.                                Chicago, IL  60615-3249
  12.                                U.S.A.
  13.  
  14.      ------------------------------------------------------------------
  15.      | Item                          | Quantity |  Price |    Total   |
  16.      |-------------------------------|----------|--------|------------|
  17.      | Robocomm version 4.2          | ________ | $40.00 | __________ |
  18.      |                               |          |        |            |
  19.      | Printed documentation         | ________ | $10.00 | __________ |
  20.      |                               |          |        |            |
  21.      | IL residents only - sales tax |          |   8%   | __________ |
  22.      |                               |          |        |            |
  23.      | Shipping (Outside U.S. only)  | ________ |  $5.00 | __________ |
  24.      |---------------------------------------------------|------------|
  25.      |                                                   |            |
  26.      |   Total amount enclosed                           | __________ |
  27.      ------------------------------------------------------------------
  28.  
  29.      Check desired disk format:    ( ) 5.25" OK      ( ) 3.5" Required
  30.                   Disk Density:    ( ) Low Required  ( ) High OK
  31.  
  32.      Payment by:  ( ) Check or money order (U.S. funds only)
  33.                   ( ) MasterCard
  34.                   ( ) Visa
  35.                   ( ) PO # ______________
  36.  
  37.      Card #: ____________________________________  Exp. Date: _________
  38.  
  39.  
  40.  Signature of card holder: ____________________________________________
  41.  
  42.  
  43.      Name:     ________________________________________________________
  44.  
  45.      Company:  ________________________________________________________
  46.  
  47.      Address:  ________________________________________________________
  48.  
  49.                ________________________________________________________
  50.  
  51.                ________________________________________________________
  52.  
  53.      Phone:    ________________________________________________________
  54.  
  55.     FLASH:  INSTANT GRATIFICATION REGISTRATION ONLINE AT GROUP ONE BBS!
  56.             Call Group One BBS and register with MasterCard or Visa and
  57.             receive your personalized ROBOUSR.DEF file immediately!
  58.                             >>>> 312-752-1258 <<<<
  59.