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Text File  |  1994-11-10  |  2KB  |  45 lines
  1.                    PEP REGISTRATION FORM AND INVOICE
  2.  
  3.                          Price          Quantity       Total
  4.  
  5. PEP-Basic                $45            __________     _______________
  6.  
  7. PEP-Extended             $75            __________     _______________
  8.  
  9. Massachusetts Residents add 5%                   _______________
  10.  
  11. Outside the USA add $5 shipping                        _______________
  12.  
  13.                                                Total:  _______________
  14.  
  15. Name:  _______________________________________________________________
  16.  
  17. Address:  ____________________________________________________________
  18.  
  19. City:  ______________________________________  State:  _______________
  20.  
  21. Country:  ___________________________________  ZIP:  _________________
  22.  
  23. Telephone:  (___________) - __________________________________________
  24.  
  25. [  ] Payment enclosed    Prefered diskette format:  [  ] 3 1/2 (1.44M)
  26. [  ] Mastercard                                     [  ] 3 1/2 (720Kb)
  27. [  ] VISA                                           [  ] 5 1/4 (360Kb)
  28.  
  29. Card number:  _______________________________  Expiration:  __________
  30.  
  31. Signature:  __________________________________________________________
  32.  
  33. From what vendor did you obtain your shareware copy of PEP:
  34.  
  35. ______________________________________________________________________
  36.  
  37. Please note:  Make checks payable to TRIONUM Inc.
  38.               The prices given above are in US dollars.
  39.               After 96DEC31 call for prices:  1-800-TRIONUM.
  40.               A signature is required for credit card payment.
  41.  
  42. Remit to:                     TRIONUM Inc.
  43.                         PO Box 305, Kendall Sq.
  44. PEP v1.6 [A2]           Cambridge, MA USA 02142
  45.