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Text File  |  1991-02-01  |  3KB  |  77 lines
  1.   EZhelp Reference Registration / User Profile
  2.  
  3.  
  4.   Brain Child Systems                Name: __________________________________
  5.   P.O. Box 3882
  6.   Austin, TX 78764              (Company): __________________________________
  7.  
  8.                                   (Title): __________________________________
  9.   date: ___________
  10.                                   Address: __________________________________
  11.  
  12.   Diskette: ___ 5 1/4"         City,State: __________________________________
  13.                                                                      Zip Code
  14.             ___ 3 1/2"       Phone Number: _________________________
  15.  
  16.                                Fax Number: _________________________
  17.  
  18.  
  19.                                             EZhelp version: _________________
  20.  
  21.   Application to use EZhelp, if any         Comments:
  22.  
  23.   ______________________________________    _________________________________
  24.  
  25.   Enhancements you would like to see:       _________________________________
  26.   
  27.   ___________________________________       _________________________________
  28.  
  29.   ___________________________________       _________________________________
  30.   
  31.   ___________________________________       _________________________________
  32.  
  33.   ___________________________________       _________________________________
  34.  
  35.  
  36.  
  37.   Charitable Donation section
  38.  
  39.      Twenty percent of your registration fee received for this package
  40.   will be donated to charity. The donation will be made to a nationally-
  41.   known, non-profit organization that works with disadvantaged youth and
  42.   youth from broken homes.
  43.  
  44.  
  45.  
  46.   EZhelp Order Form
  47.  
  48.  
  49.  
  50.   EZhelp registration fee ............................. 25.00     _______
  51.  
  52.   Texas residents add 8% sales tax .................... X  8%     _______
  53.  
  54.   Single update fee for registered users ..............  5.00     _______
  55.  
  56.                                              Total enclosed       _______
  57.  
  58.  
  59.  
  60.  
  61.                                                       Brain Child Systems
  62.                          Make checks payable to:      P.O. Box 3882
  63.                                                       Austin, TX 78764
  64.  
  65.  
  66.  
  67.   Terms:  Check or Money Order, payment in U.S. dollars. All orders
  68.           outside of the contintental United States must be prepaid.
  69.           Registered users will be notified of updates, and will
  70.           receive one free, less media and shipping costs.
  71.  
  72.   EZhelp Reference
  73.   (C) Copyright 1990-1991, Brain Child Systems.
  74.   All rights reserved.
  75.  
  76.  
  77.