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  1.                    CARCH Ver 1.05 Registration form
  2.  
  3.                  Please complete this form and mail to:
  4.  
  5.   Leonardus Leonardi
  6.   Snail Mail:                     E-Mail:
  7.   Buana Pesanggrahan VI/8         Compuserve ID 73441,1702
  8.   South Jakarta - Indonesia       Via Internet 73441.1702@compuserve.com
  9.   16514
  10.  
  11.  
  12.             Date:_____________
  13.  
  14.        Your Name:_________________________________________________
  15.  
  16.          Address:___________________________________________________
  17.  
  18.         City, ST:__________________________________________________
  19.  
  20.              ZIP:_______________
  21.  
  22.          Phone.#:_____________________________
  23.  
  24.          CIS ID#:_____________________________
  25.  
  26.        Internet#:__________________________________________________
  27.  
  28.        Disk Type:___ 3.5"  ___ 5.25" (check one)
  29.  
  30.        $10.00 enclosed as (check one):
  31.  
  32.                 ____Check     ____Transfer  ____Money Order
  33.  
  34.             ( Outside Indonesia please Add $5.00 for shipping )
  35.  
  36.   If it a Check or Money Order please make payable to:  Mr. Widyosutirto
  37.  
  38. If it a Transfer method (suggested method), please transfer your money to:
  39.                   Mr. Widyosutirto, Acc. Number: 1100013825
  40.                 CitiBank (Indonesia - branch Jendral Sudirman)
  41.       (Don't forget to mail the Photocopy of the Transfer Provement)
  42.  
  43. Where did you get your copy of CARCH?
  44.  
  45. _______________________________________________________________________________
  46.  
  47.  
  48.  
  49. What do you like the most about CARCH?
  50.  
  51. _______________________________________________________________________________
  52.  
  53. _______________________________________________________________________________
  54.  
  55. _______________________________________________________________________________
  56.  
  57. _______________________________________________________________________________
  58.  
  59.  
  60.  
  61. What would you like to see changed?
  62.  
  63. _______________________________________________________________________________
  64.  
  65. _______________________________________________________________________________
  66.  
  67. _______________________________________________________________________________
  68.  
  69. _______________________________________________________________________________
  70.  
  71.  
  72.  
  73. What other types of programs would you like to see written in the future?
  74.  
  75. _______________________________________________________________________________
  76.  
  77. _______________________________________________________________________________
  78.  
  79. _______________________________________________________________________________
  80.  
  81. _______________________________________________________________________________
  82.