home *** CD-ROM | disk | FTP | other *** search
/ Kids Cube / 7_Science.iso / nutriqz / qorder.frm < prev    next >
Encoding:
Text File  |  1991-09-05  |  2.3 KB  |  61 lines
  1.                QUIZZIA REGISTRATION CARD AND QUESTIONNAIRE
  2.  
  3. By registering, you will receive the latest version of Quizzia without
  4. the shareware screens, the complete nutrition database consisting of over
  5. 400 questions, notification of future versions of Quizzia which will be
  6. available to registered users for $5.00, and notification of future
  7. question databases as they are developed.
  8.  
  9. Date   _______________
  10.  
  11. Organization (if any) ___________________________________________
  12.  
  13. Name   __________________________________________________________
  14.  
  15. Address__________________________________________________________
  16.  
  17. City   ________________________ State________ Zip Code___________
  18.  
  19.  
  20. Quantity        Product                          Price             Total
  21.  
  22. ________  Quizzia 1.1 on 5.25" 360KB diskette    $17.95           ___________
  23.  
  24. ________  Quizzia 1.1 on 3.50" 720KB diskette    $17.95           ___________
  25.  
  26.                                           Shipping and handling      $ 1.50
  27.  
  28.                          5% sales tax (Maryland customers only)   ___________
  29.  
  30.                                                  Total enclosed   ___________
  31.  
  32. Please make check payable to and mail to:      Thomas M. Roddy
  33.                                                P.O. Box 325
  34.                                                Columbia, MD  21045-0325
  35.  
  36.                  Please allow 7-10 days for delivery
  37. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
  38. 1. Where are you primarily using Quizzia? (home, school, work, etc.)
  39.  
  40. ____________________________________________________________________________
  41.  
  42. 2. If there was one thing about the program you would change, what would
  43. it be?
  44.  
  45. ____________________________________________________________________________
  46.  
  47. ____________________________________________________________________________
  48.  
  49. 3. What other topics would you like to see developed for Quizzia?
  50.  
  51. ___________________________________________________________________________
  52.  
  53. 4. Additional comments, complaints, praise:________________________________
  54.  
  55. ___________________________________________________________________________
  56.  
  57. ___________________________________________________________________________
  58.  
  59. Thank you very much for your time. Your input will help determine the
  60. future of Quizzia!
  61.