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  1.  
  2. REGISTRATION FORM  Screen Saver Version 5.1
  3. ========================================================================
  4.  
  5.  
  6.                INDIVIDUAL AND SITE LICENSE REGISTRATION FORM
  7.                =============================================
  8.  
  9.           Screen Saver Version 5.1
  10.  
  11.           License fee:     1 copy      -  $20.00
  12.                         6-25 copies    - $100.00
  13.                        26-50 copies    - $200.00
  14.                       51-100 copies    - $400.00
  15.                       Unlimited copies - $500.00
  16.  
  17.  
  18.                  Date: ____/____/____                      (SCSV51)
  19.  
  20.          Contact Name: ________________________________________
  21.  
  22.          Company Name: ________________________________________
  23.  
  24.               Address: ________________________________________
  25.  
  26.                  City: ____________________  State: ____  Zip: __________
  27.  
  28.             Telephone: (______) _________________  Ext: _______
  29.  
  30.         Compuserve ID: _____________           Monitor Type:  _______
  31.  
  32.         Make of Computer: ___________________  Amount of RAM: _______
  33.  
  34.         Size of Floppy Disk:  [  ] 5.25"   [  ] 3.5"
  35.  
  36.         Number of copies: _____              Amount enclosed: ______
  37.  
  38.  
  39.          TERMS:  No credit cards or CODs, please.
  40.  
  41.                  Make checks payable to: Tom Donnelly Computer Software
  42.                  Checks drawn on a U.S. bank in U.S. funds.
  43.                  International bank or postal money orders in U.S. funds.
  44.  
  45.                  Purchase orders will be accepted and invoiced.
  46.  
  47.                  Please attach your check and mail to:
  48.  
  49.                  Tom Donnelly Computer Software
  50.                  P.O. Box 3856
  51.                  San Dimas, CA  91773
  52.  
  53.  
  54.           THANK YOU FOR SUPPORTING SHAREWARE.
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