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  1.  
  2.  
  3.  
  4.                R E G I S T R A T I O N    F O R M
  5.  
  6.  
  7.  
  8. DATE:                    _________________________________________
  9.  
  10. YOUR NAME:               _________________________________________
  11.  
  12. COMPANY NAME:            _________________________________________
  13.  
  14. STREET ADDRESS:          _________________________________________
  15.  
  16. CITY, STATE, ZIP CODE:   _________________________________________
  17.  
  18. PHONE NUMBER:            _________________________________________
  19.  
  20. COMPUTER BRAND AND MODEL:_________________________________________
  21.  
  22. DISKETTE SIZE (Check One)  3.5 inch [ ]     -or-    5.25 Inch [ ]
  23.  
  24. Please Indicate the source of your copy of COMS: 
  25.  
  26. ==================================================================
  27.  
  28.                     DESCRIPTION                            AMOUNT
  29. --------------------------------------------------        -------
  30. Latest Version of Customer Order Management System         $69.00
  31.  
  32. Customer Order Management System User's Manual                N/C
  33.  
  34. Software Updates For One Year                                 N/C
  35.  
  36. Letter or Phone Support                                       N/C
  37.  
  38. DataBase File Compression Utility (ISAMPACK.EXE)              N/C
  39.  
  40. Shipping & Handling Charge                                   5.00
  41.                                                           -------
  42.     Total                                                  $74.00
  43.                                                           =======
  44.  
  45. Make check payable to: Beshears Software Associates
  46.  
  47. Mail Registration Form and Payment to:
  48.  
  49.                   Beshears Software Associates
  50.                         5710 Rita Street
  51.                       Southside, AL  35903 
  52.  
  53. coms13