Software Registration Form Purchase Order Date:________ ____________________________________________________________________ Name: [1] [2] [3] Phone/FAX: [4] [5] Email: [6] Comments: [7] Payment Method..........: [8] Purchase Order #.......: [9][10][11] Products Ordered: ([12]) ScrapIt Pro 5.33 ($20 each)..............: [13] ([14]) QuickScrap 1.1 ($15 each)................: [15] ([16]) ScrapIt Pro & QuickScrap ($30 each): [17] ([18]) QuickPop ($10 each)...........................: [19] ([20]) ViewFont ($5 each)..............................: [21] ([22]) ColorFall ($10 each)...........................: [23] ([24]) Escape! ($10 each)..............................: [25] ([26]) SideMinder ($10 each)........................: [27] Quantity Discount...........: [28] Send Latest?...(adds $5): [29] Disk Size (800k or HD): [30] Sales Tax (CA Only).......: [31] Note: Sales Tax is only collected if you've requested a disk and you live in California Total Due.........................: [32] [33] ____________________________________________________________________ Please send this form to: John V. Holder Email addresses (AOL is preferred): 1734 "S" Street America Online: JohnHolder Eureka, CA 95501 Internet...........: jvholder@northcoast.com USA CompuServe....: 75040,1126 FAX: (707) 443-3813 Home Page: http://www.northcoast.com/~jvholder (check for the latest new releases and updates!)