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Text File  |  1994-05-22  |  1KB  |  35 lines
  1.     
  2.      
  3.      APPLICATION FOR RECEIVING COMMISSION CHECKS
  4.      
  5.      
  6.      COMPANY NAME: ..................................................
  7.      
  8.      NAME: ................................. DATE OF BIRTH: .........
  9.      
  10.      ADDRESS: .......................................................
  11.      
  12.      CITY: ..........................................................
  13.      
  14.      STATE: .................................. ZIP: .................
  15.      
  16.      PHONE: ....................................
  17.      
  18.      (Formerly resale94.zip)   PRE-REGISTERED copy of INTROKIT.ZIP  $2.00
  19.      
  20.                        California orders PLEASE add your sales tax  .......
  21.      
  22.                                              SHIPPING POSTAGE PAID  ..n/a..
  23.      
  24.           Specify: (3.5 720K) disk or (5.25 360K) disk:       TOTAL .......
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  26.      
  27.      Make check or money order out to: Kevin King (or) DISK-COUNT DATA
  28.      
  29.                           Kevin King, SysOp/Owner
  30.                           Disk-Count Data
  31.                           P.O. Box 277482
  32.                           Sacramento, CA. 95827-7482
  33.                           916-381-8746 VOICE
  34.                           916-381-2851 24-HR BBS
  35.