home *** CD-ROM | disk | FTP | other *** search
-
- VUDU Quick Registration Form BINARY SYSTEMS
- ____________________________ PO BOX 10714
- FARGO ND 58106 USA
- Disk type desired: ___ 5.25" ___ 3.5"
- _________________________________________________________________________
-
- ___ Copy(s) VUDU for PDS7+ ___ Copy(s) VUDU for QB4+ -- x $25.00
-
- Additional MASM source code (Add $5.00 one time) -- _________
-
- ___ Express Delivery ___* Electronic Transfer (Add $10.00) -- _________
-
- Orders outside the US add $5.00 (Sent as an Airmail Letter) -- _________
- ____________
-
- Total Amount Enclosed -- _________
-
-
- YOUR COMPLETE SHIPPING ADDRESS:
-
- ___________________________________________________
-
- ___________________________________________________
-
- ___________________________________________________
-
- ___________________________________________________
-
- Make check or money order payable to Binary Systems. Thank You!
-
-
- * To arrange an electronic transfer call (701)281-2732 or give your
- phone number and name here to have Binary Systems contact you as
- soon as we receive your registration:
-
- PHONE:(______)_____-_________
-
- NAME: _______________________________
-