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Text File  |  1994-11-26  |  5KB  |  60 lines
  1. +----------------------------------------------------------------------------+
  2. |   Screen Saver Registration Form, Version 1.01A                            |
  3. |                                                                            |
  4. |   Please send your registration information (this form filled out) and     |
  5. |   a check or money order for $10 to the following address:                 |
  6. |                                                                            |
  7. |                       Vincent Greene                                       |
  8. |                       200 N Melanie Lane                                   |
  9. |                       Tucson, AZ 85710                                     |
  10. |                                                                            |
  11. |   Please make all checks out to "Vincent Greene."                          |
  12. |                                                                            |
  13. |   If possible, please draw checks on a U.S. Bank in U.S. Funds.            |
  14. |----------------------------------------------------------------------------|
  15. |                                                                            |
  16. |   Your Name:   _______________________________________________________     |
  17. |                                                                            |
  18. |   Address:     _______________________________________________________     |
  19. |                                                                            |
  20. |                _______________________________________________________     |
  21. |                                                                            |
  22. |   City:        ________________________________  State: ______________     |
  23. |                                                                            |
  24. |   Zip or Postal Code:  _________________      Country:  ______________     |
  25. |                                                                            |
  26. |                                                                            |
  27. |   OPTIONAL:  (To be used in case of support needs)                         |
  28. |                                                                            |
  29. |   Home Phone:  ____________________   Work Phone:  ___________________     |
  30. |                                                                            |
  31. |   Email:       _______________________________________________________     |
  32. |                                                                            |
  33. |   Note: If an Email address is provided, I will send your registration     |
  34. |         information via Email and regular snail mail.  I will also add     |
  35. |         your Email address to a list to receive product updates and        |
  36. |         other useful notices via Email.                                    |
  37. |----------------------------------------------------------------------------|
  38. |   The following information is optional and will only be used to determine |
  39. |   which BBS, FTP sites, and distributors should be provided with product   |
  40. |   updates.                                                                 |
  41. |                                                                            |
  42. |   Where did you get a copy of Screen Saver:   ________________________     |
  43. |                                                                            |
  44. |   ____________________________________________________________________     |
  45. |                                                                            |
  46. |----------------------------------------------------------------------------|
  47. |   Suggestions:                                                             |
  48. |                                                                            |
  49. |                                                                            |
  50. |                                                                            |
  51. |                                                                            |
  52. |                                                                            |
  53. |                                                                            |
  54. |                                                                            |
  55. |                                                                            |
  56. |                                                                            |
  57. |                                                                            |
  58. |                                                                            |
  59. +----------------------------------------------------------------------------+
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