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Text File  |  1997-03-23  |  1KB  |  50 lines
  1. Software Registration Form
  2. ____________________________________________________________________
  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:
  15. [8]
  16. [9]
  17. [10]
  18. [11]
  19.  
  20. Products Ordered:
  21. ([12]) ScrapIt Pro 5.33 ($20 each)........:   [13]
  22. ([14]) QuickScrap 1.1 ($15 each)..........:   [15]
  23. ([16]) ScrapIt Pro & QuickScrap ($30 each):   [17]
  24. ([18]) QuickPop ($10 each)................:   [19]
  25. ([20]) ViewFont ($5 each).................:   [21]
  26. ([22]) ColorFall ($10 each)...............:   [23]
  27. ([24]) Escape! ($10 each).................:   [25]
  28. ([26]) SideMinder ($10 each)..............:   [27]
  29.  
  30. Quantity Discount............:   [28]
  31. Send Latest on disk?(adds $5):   [29]
  32. Disk Size (800k or HD).......:   [30]
  33. Sales Tax (CA Only)..........:   [31]
  34. Note: Sales Tax is only collected if you've requested a disk and you live in California
  35.  
  36. Total Due....................:   [32]
  37.  
  38. [33]
  39. ____________________________________________________________________
  40. Email this registration form to:
  41.  
  42. John V. Holder                   Email addresses (AOL is preferred):
  43. 1734 "S" Street                  America Online:  JohnHolder
  44. Eureka, CA  95501                Internet......:  jvholder@northcoast.com
  45.                                  CompuServe....:  75040,1126
  46. FAX:  (707) 443-3813
  47.  
  48. Home Page:   http://www.northcoast.com/~jvholder
  49. (check for the latest new releases and updates!)
  50.