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Text File  |  1993-02-14  |  1.1 KB  |  45 lines
  1.  
  2.                 Zip A Directory 1.0   Registration Form
  3.  
  4.                             Send to:
  5.  
  6.                             Gregory Sherman
  7.                             4750 Sawtelle Blvd
  8.                             Culver City  CA 90230
  9.  
  10.                             Enclose $4
  11.  
  12.                         
  13.  
  14.   Name 
  15.        -------------------------------------------------------------
  16.  
  17.   Street Address                                                 
  18.                   --------------------------------------------------
  19.  
  20.   City, State/Province   
  21.                          -------------------------------------------
  22.  
  23.   ZIP or Postal Code  
  24.                       ---------------------------------------
  25.  
  26.   Country
  27.           ----------------------------------------------------
  28.  
  29.  
  30.   E-Mail Address (if any) 
  31.                           ------------------------------------------
  32.   
  33.   ------------------------------------------------------------------
  34.  
  35.  
  36.  
  37.   Where did you obtain Zip A Directory?
  38.  
  39.   
  40.   -------------------------------------------------------------------
  41.  
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  43.  
  44.                       Thanks for registering!
  45.