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Text File  |  1992-07-09  |  2KB  |  66 lines
  1.  
  2.                            --------------------------
  3.                            Registration Form FastEcho
  4.                            --------------------------
  5.  
  6. FastEcho can be registed with this form for users in the United States and
  7. Canada. If you/your boss are a member of FidoNet or RANet, it's possible to
  8. send your key(s) via crash-mail directly to you. Otherwise the key(s) have
  9. to be sent on floppy-disk with additional costs for handling.
  10.  
  11. Hereby I order a key for FastEcho.
  12.  
  13. Name       :______________________________________________________________
  14. Street     :______________________________________________________________
  15. Postalcode :________
  16. City       :______________________________________________________________
  17. Country    :______________________________________________________________
  18.  
  19. Pointnumber:__:____/____.____           [  ] FidoNet    [  ] RANet
  20. BBS name   :______________________________________________________________
  21.             (only if available)
  22.  
  23.  
  24. [  ] Key(s) for FastEcho POINT US$ 15, CAN$ 20             :  $ ____.--
  25. [  ] Key(s) for FastEcho NODE  US$ 25, CAN$ 32             :  $ ____.--
  26. [  ] Key(s) for FastEcho UPGRADE (POINT TO NODE)
  27.                                US$ 10, CAN$ 13             :  $ ____.--
  28.      Number of existing POINT Key: _____
  29.  
  30. [  ] Send key(s) per disk, add US$ 4, CAN$6 Handling       :  $    _.--
  31.  
  32.         [  ] 5.25"      [  ] 3.5"
  33. _______________________________________________________________________
  34.                                                 Total      :  $     .--
  35.                                                            ============
  36.  
  37. Payment Enclosed:
  38.  
  39. [  ] CASH          [  ] CHECK         [  ] MONEY ORDER
  40.  
  41. [  ] Visa          [  ] MasterCard
  42.  
  43. Credit Card Number: __________________________________________
  44.  
  45. Expiration Date: ___/___
  46.  
  47. Full Name of Card Holder : ______________________________________________
  48.  
  49. Signature of Card Holder : ______________________________________________
  50.  
  51.  
  52.  
  53. Make sure all checks are payable to:   DIRECT COMPUTER RESOURCES
  54.  
  55. Please send this form to: Dave Rasche
  56.               Direct Computer Resources    
  57.                           10640 Torrey Road
  58.                           Willis, MI 48191
  59.                           USA
  60.  
  61.                                              Date: __-__-19__
  62.  
  63.                                              Signature:
  64.  
  65.                                              _______________________
  66.