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Text File  |  1996-11-19  |  1.7 KB  |  55 lines
  1. Software Registration Form
  2. ____________________________________________________________________
  3. Name:
  4. [1]
  5. [2]
  6. [3]
  7. Phone/FAX:   [4]       [5]
  8.  
  9. Email:   [6]
  10.  
  11. Comments:   [7]  
  12.  
  13. Payment Method:
  14. [8]
  15. [9]
  16. [10]
  17. [11]
  18.  
  19. Signature (when sending via standard mail):___________________________________
  20.  
  21. Products Ordered:
  22. ([12]) ScrapIt Pro ($20 each).......................:   [13]
  23. ([14]) QuickScrap ($15 each)........................:   [15]
  24. ([16]) ScrapIt Pro & QuickScrap ($30 each):   [17]
  25. ([18]) QuickPop ($10 each)...........................:   [19]
  26. ([20]) ViewFont ($5 each)..............................:   [21]
  27. ([22]) ColorFall ($10 each)...........................:   [23]
  28. ([24]) Escape! ($10 each)..............................:   [25]
  29. ([26]) SideMinder ($10 each)........................:   [27]
  30.  
  31. Quantity Discount...........:   [28]
  32. Send Latest?...(adds $5):   [29]
  33. Disk Size (800k or HD):   [30]
  34. Sales Tax (CA Only).......:   [31]
  35. Note: Sales Tax is only
  36. collected if you've requested
  37. a disk and you live in
  38. California
  39.  
  40. Total Due.........................:   [32]
  41.  
  42. [33]
  43. ____________________________________________________________________
  44. FAX, send via stail or email this registration form to:
  45.  
  46. John V. Holder                                                           Email addresses (AOL is preferred):
  47. 1734 "S" Street                                                         America Online:  JohnHolder
  48. Eureka, CA  95501                                                     Internet...........:  JohnHolder@aol.com
  49. USA                                                                            CompuServe....:  75040,1126
  50.  
  51. FAX:  (707) 443-3813
  52.  
  53. Home Page:   http://www.northcoast.com/~jvholder
  54. (check for the latest new releases and updates!)
  55.