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Text File  |  1994-12-07  |  4KB  |  133 lines
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  2.                   Stevenson Technical Services, Inc. (STSI)
  3.                             108 Second Avenue West
  4.                             Bertha, MN 56437-0297
  5.                           Phone/FAX: (218) 924-2050
  6.                     The Bertha BBS: (218) 924-2060, N,8,1
  7.  
  8.                       Replicator 1.10 Registration Form
  9.  
  10.    Qty    Description                                   Price Each     Total
  11.  
  12.   _____   Replicator 1.10 Single-User Registration         $49.95   ________
  13.             Includes Printed Manual, 3 1/2" & 5 1/4" Diskettes,
  14.             and A Registration Number.
  15.  
  16.   _____   Replicator 1.10 Site-License (Users? ___)        ______   ________
  17.             (Same price breaks apply for site-licensing.)
  18.  
  19.            # of Users      Price           # of Users       Price
  20.            ----------     -------          ----------      -------
  21.                 5    ->   $150.00              50     ->   $600.00
  22.                10    ->   $300.00             100     ->   $750.00
  23.                20    ->   $450.00            More?    ->    CALL
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  26.                                                        Sub-Total:   ________
  27.  
  28.                           Minnesota Residents Add 6.5% Sales Tax:   ________
  29.  
  30.         Shipping/Handling (USA/Canada = $5.00, Foreign = $10.00):   ________
  31.  
  32.                                                            Total:   ________
  33.  
  34.      Name: ____________________________  Company: __________________________
  35.  
  36.   Address: _________________________________________________________________
  37.  
  38.      City: ___________________________  State: _____  Zip Code: ____________
  39.  
  40.   Country: ___________________________  Phone: ______________________
  41.  
  42.   Please Register Replicator To This Name: _______________________________
  43.  
  44.  
  45.   Method of Payment: ___ Visa/MC   ___ American Express   ___ Discover
  46.                      ___ Check/Money Order Enclosed
  47.             (Checks/MO's must be in U.S. Funds drawn on a U.S. Bank!)
  48.  
  49.  
  50.   Credit Card #: _________________________________  Expiration Date: ___/___
  51.  
  52.   Name on Card: _______________________  Signature: ________________________
  53.  
  54.   Comments / Suggestions: __________________________________________________
  55.  
  56.   __________________________________________________________________________
  57.  
  58.   __________________________________________________________________________
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  66.                                      Page 1
  67.  
  68.   Please take a minute to answer the following questions.  Your answers
  69.   will assist us in improving and marketing Replicator.  (Check all that
  70.   apply.)
  71.  
  72.  
  73.   Where did you hear about Replicator?
  74.  
  75.   [ ] BBS             [ ] Catalog/Magazine    [ ] Friend/Relative
  76.   [ ] Rack Vendor     [ ] User's Group        [ ] Other _______________
  77.  
  78.   Please provide name of BBS/Catalog/Magazine/User's Group, (if possible)
  79.  
  80.   ______________________________________________________________________
  81.  
  82.  
  83.   What operating systems / environments do you use?
  84.  
  85.   [ ] DOS    [ ] Windows   [ ] DESQview/DESQview/X     [ ] OS/2
  86.  
  87.  
  88.   What do you use Replicator for?  _________________________________________
  89.  
  90.  
  91.   What feature(s) do you like the most about Replicator?  __________________
  92.  
  93.   __________________________________________________________________________
  94.  
  95.  
  96.   What feature(s) would you like to see added to Replicator?  ______________
  97.  
  98.   __________________________________________________________________________
  99.  
  100.  
  101.   Additional Comments:  ____________________________________________________
  102.  
  103.   __________________________________________________________________________
  104.  
  105.  
  106.   May We Quote You?    [ ] Yes    [ ] No    [ ] Doesn't Matter
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  132.                                      Page 2
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