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Text File  |  1990-11-13  |  2.2 KB  |  55 lines
  1.  
  2.               Please support quality SHAREWARE by registering it.
  3.                         We thank you for your support.
  4.  
  5.                           PC-INFO REGISTRATION FORM
  6.  
  7.                            CHEAT RIVER ENGINEERING
  8.                               23 Richwood Place
  9.                                  P.O. Box 289
  10.                                  Denville, NJ
  11.                                   07834-0289
  12.  
  13.             Purchase orders for less than $150 must be prepaid.
  14.  
  15.      PC-INFO Registration                            $15.00  or  ______
  16.  
  17.      Overseas (Non-US/CANADA) shipping and handling  $ 5.00  or  ______
  18.      (Required even with Prepayment!)
  19.                                                           TOTAL $______
  20.  
  21.  
  22.      Payment by: Check (U.S. bank or branch) enclosed               ___
  23.                  American Express Card                              ___
  24.                  Master Card                                        ___
  25.                  Optima Card                                        ___
  26.                  Traveller's Checks (Payable in U.S. dollars ONLY!) ___
  27.                  VISA                                               ___
  28.  
  29.                  Disk Size Preferred:     5 1/4" ______   3 1/2" ______
  30.                  (If no preference is stated, 5 1/4" will be supplied.)
  31.  
  32. Name     ___________________________________________________________________
  33.  
  34. Address  ___________________________________________________________________
  35.  
  36.          ___________________________________________________________________
  37.  
  38. City     ________________________________ State ______ Zip Code ____________
  39.  
  40. Country  ___________________________________________________________________
  41.  
  42.          >>>>>>..... Following only needed for Credit Card .....<<<<<<
  43.  
  44. Work Phone  (____) __________________  Home Phone   (____)  ________________
  45.  
  46. Card #  ______________________________________ Expiration Date _____________
  47.  
  48. Name of Cardholder  ________________________________________________________
  49.  
  50. Signature __________________________________________________________________
  51.  
  52.  Credit card orders may be placed via telephone at 201-627-5460 or via
  53.     an Easyplex message on Compuserve addressed to us at 73710,2611
  54.  
  55.