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Text File  |  1996-06-30  |  1KB  |  48 lines
  1. Product:  QuickPop 2.11
  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. Signature (when sending via standard mail):___________________________________
  21.  
  22. Price per copy................:   $10.00
  23. Number of copies............:   [12]
  24. Quantity Discount...........:   [13]
  25. Send Latest?...(adds $5):   [14]
  26. Disk Size (800k or HD):   [15]
  27. Sales Tax (CA Only).......:   [16]
  28. Note: Sales Tax is only
  29. collected if you've requested
  30. a disk and you live in
  31. California
  32.  
  33. Total Due.........................:   [17]
  34.  
  35. [18]
  36. ____________________________________________________________________
  37. FAX, send via stail or email this registration form to:
  38.  
  39. John V. Holder                                                           Email addresses (AOL is preferred):
  40. 1734 "S" Street                                                         America Online:  JohnHolder
  41. Eureka, CA  95501                                                     Internet...........:  JohnHolder@aol.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.