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Text File  |  1997-03-23  |  2KB  |  48 lines
  1. Software Registration Form             Purchase Order     
  2.                                              Date:________
  3. ____________________________________________________________________
  4. Name:
  5. [1]
  6. [2]
  7. [3]
  8. Phone/FAX:   [4]       [5]
  9.  
  10. Email:   [6]
  11.  
  12. Comments:   [7]  
  13.  
  14. Payment Method..........:   [8]
  15. Purchase Order #.......:   [9][10][11]
  16.  
  17. Products Ordered:
  18. ([12]) ScrapIt Pro 5.33 ($20 each)..............:   [13]
  19. ([14]) QuickScrap 1.1  ($15 each)................:   [15]
  20. ([16]) ScrapIt Pro & QuickScrap ($30 each):   [17]
  21. ([18]) QuickPop ($10 each)...........................:   [19]
  22. ([20]) ViewFont ($5 each)..............................:   [21]
  23. ([22]) ColorFall ($10 each)...........................:   [23]
  24. ([24]) Escape! ($10 each)..............................:   [25]
  25. ([26]) SideMinder ($10 each)........................:   [27]
  26.  
  27. Quantity Discount...........:   [28]
  28. Send Latest?...(adds $5):   [29]
  29. Disk Size (800k or HD):   [30]
  30. Sales Tax (CA Only).......:   [31]
  31. Note: Sales Tax is only collected if you've requested a disk and you live in California
  32.  
  33. Total Due.........................:   [32]
  34.  
  35. [33]
  36. ____________________________________________________________________
  37. Please send this form to:
  38.  
  39. John V. Holder                                                           Email addresses (AOL is preferred):
  40. 1734 "S" Street                                                         America Online:  JohnHolder
  41. Eureka, CA  95501                                                     Internet...........:  jvholder@northcoast.com
  42. USA                                                                            CompuServe....:  75040,1126
  43.  
  44. FAX:  (707) 443-3813
  45.  
  46. Home Page:   http://www.northcoast.com/~jvholder
  47. (check for the latest new releases and updates!)
  48.