home *** CD-ROM | disk | FTP | other *** search
/ Chip 1999 December / Chip_1999-12_cd.bin / zkuste / Svet_OS2 / MED_125 / MEDO125E.ZIP / medo125e / REGISTER.TXT < prev   
Encoding:
Text File  |  1999-03-03  |  1.7 KB  |  58 lines
  1.         ------------------------------------------------------------------
  2.                        MED V1.25 for OS/2 registration form
  3.         ------------------------------------------------------------------
  4.  
  5.         Please fill in the needed information and send this form to
  6.  
  7.         Via mail:    Matthias Pfersdorff
  8.                      Marie-Alexandrastr. 3
  9.                      D-76135 Karlsruhe
  10.                      Germany
  11.  
  12.         Via E-Mail:  med@utopia-planitia.de
  13.  
  14.         ------------------------------------------------------------------
  15.  
  16.         Please fill in your name and address:
  17.  
  18.         __________________________________________________
  19.  
  20.         __________________________________________________
  21.  
  22.         __________________________________________________
  23.  
  24.         __________________________________________________
  25.  
  26.  
  27.         Fax    : ___________________________
  28.  
  29.  
  30.         E-Mail : ___________________________
  31.  
  32.  
  33.         OS     : ( ) OS/2 Warp 4  ( ) OS/2 Warp 3  ( ) OS/2 Warp Connect
  34.  
  35.         I have paid the registration fee ($25, DM40.-)
  36.  
  37.         ( ) via Bank Transfer to        Volksbank Karlsruhe
  38.             (use only from inside       Account       76 778 6
  39.              Germany)                   BLZ           661 900 00
  40.  
  41.         ( ) personal check
  42.         ( ) cash
  43.  
  44.  
  45.  
  46.        ________________            _____________________________
  47.        date                        signature
  48.  
  49.  
  50.        comments and suggestions:
  51.  
  52.        ________________________________________________________________
  53.  
  54.        ________________________________________________________________
  55.  
  56.        ________________________________________________________________
  57.  
  58.