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Text File  |  1993-03-24  |  4KB  |  51 lines
  1.     ┌───────────────────────────────────────────────────────────────────┐
  2.     │                    ╔═══════════════════════╗                      │
  3.     │                    ║   REGISTRATION FORM   ║                      │
  4.     │                    ╚═══════════════════════╝                      │
  5.     │  ───────────────────────────────────────────────────────────────  │
  6.     │  Do you want to become a registred user of this great program?    │
  7.     │  No problem! Just send this form to the adress below.             │
  8.     │  ───────────────────────────────────────────────────────────────  │
  9.     │  Name of the program: ELECTROBODY         Date:________           │
  10.     │  ───────────────────────────────────────────────────────────────  │
  11.     │                                                                   │
  12.     │  Name_________________________________________________            │
  13.     │                                                                   │
  14.     │  First name___________________________________________            │
  15.     │                                                                   │
  16.     │  Street_______________________________________________            │
  17.     │                                                                   │
  18.     │  Post code________ City_______________________________            │
  19.     │                                                                   │
  20.     │                                                                   │
  21.     │  Signature:___________________________________________            │
  22.     │  ───────────────────────────────────────────────────────────────  │
  23.     │      ┌─────────────────────────────────────────────────────┐      │
  24.     │      │  []  ELECTROBODY                           $29.00   │      │
  25.     │      └─────────────────────────────────────────────────────┘      │
  26.     │  ───────────────────────────────────────────────────────────────  │
  27.     │  Please send to:                                                  │
  28.     │         ┌─────────────────────────────────────────────┐           │
  29.     │         │  CDV Software      │  Phone 0049721-97224-0 │           │
  30.     │         │                    │                        │           │
  31.     │         │  Postfach 2749     │  Fax   0049721-2 13 14 │           │
  32.     │         │  7500 Karlsruhe 1  │                        │           │
  33.     │         │                    │  CIS   [100022,274]    │           │
  34.     │         │  GERMANY           │                        │           │
  35.     │         └─────────────────────────────────────────────┘           │
  36.     │  ───────────────────────────────────────────────────────────────  │
  37.     │  ──────────────────────   Delivery  ────────────────────────────  │
  38.     │  ───────────────────────────────────────────────────────────────  │
  39.     │     on   [] EUROCARD    [] AMERICAN EXPRESS    [] VISA            │
  40.     │                                                                   │
  41.     │             Card number:_______________________________           │
  42.     │                                                                   │
  43.     │             Expiration date:___________________________           │
  44.     │                                                                   │
  45.     │             Card holder:_______________________________           │
  46.     │  ───────────────────────────────────────────────────────────────  │
  47.     │     in   [] CASH                                                  │
  48.     │  ───────────────────────────────────────────────────────────────  │
  49.     │       Alle prices plus postage and packing           $12.00       │
  50.     └───────────────────────────────────────────────────────────────────┘
  51.