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  1.                            imgTECH/IV ORDER FORM
  2.  
  3.  
  4.  
  5.        When you register imgTECH/IV we'll send you a personally registered
  6.        copy of the latest version of imgTECH/IV.
  7.        
  8.        To register imgTECH/IV, please fill out the blanks below and send
  9.        check or money order (in US currency) to:
  10.        
  11.              imgTECH
  12.              Box 31436, 3045 Robie St.
  13.              Halifax, NS, Canada
  14.              B3K 5Z1
  15.  
  16.          email: ing1@ac.dal.ca
  17.  
  18.  
  19.        
  20.        Name      _________________________________________________________
  21.        
  22.        Company   _________________________________________________________
  23.        
  24.        Address   _________________________________________________________
  25.        
  26.                  _________________________________________________________
  27.        
  28.                  _________________________________________________________
  29.  
  30.  
  31.        Telephone _________________________________________________________
  32.        
  33.        Email     _________________________________________________________
  34.        
  35.        
  36.        
  37.        imgTECH/IV registration ................... $20.00 ________
  38.        
  39.        Shipping and Handling .....................  $5.00 ________
  40.  
  41.        Nova Scotia Residents add 11% PST .........  $2.75 ________
  42.        
  43.        Total in US currency drawn on a US bank ... $ _____________
  44.        
  45.        
  46.        Floppy disk size:      ( )   3 1/2
  47.                               ( )   5 1/4
  48.        
  49.        
  50.        Comments / Suggestions  ___________________________________________
  51.        
  52.        ___________________________________________________________________
  53.        
  54.        ___________________________________________________________________
  55.        
  56.        ___________________________________________________________________
  57.        
  58.        ___________________________________________________________________
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