home *** CD-ROM | disk | FTP | other *** search
- ' APPLICATION FORM FOR GBLIB2.EXE REGISTRATION KEY
- ' ================================================
- '
- ' All information is deemed private and confidential
- ' If a field does not apply, then type 'Not Applicable'
- '
- ' ============================================================================
- '
- ' First Name _________________________________________________________________
- '
- ' Last Name __________________________________________________________________
- '
- ' Date of Birth ______________________________________________________________
- '
- ' ============================================================================
- '
- ' EMail Address 1 ____________________________________________________________
- '
- ' EMail Address 2 ____________________________________________________________
- '
- ' EMail Address 3 ____________________________________________________________
- '
- ' ============================================================================
- '
- ' Home Adddress Line 1 _______________________________________________________
- '
- ' Home Adddress Line 2 _______________________________________________________
- '
- ' Home Adddress City/Town ____________________________________________________
- '
- ' Home Adddress State/County _________________________________________________
- '
- ' Home Adddress Country ______________________________________________________
- '
- ' Home Telephone Number (Inc Country code)____________________________________
- '
- ' ============================================================================
- '
- ' Profession/Job Title _______________________________________________________
- '
- ' Employer/Business Address 1 ________________________________________________
- '
- ' Employer/Business Address 2 ________________________________________________
- '
- ' Employer/Business Address 3 ________________________________________________
- '
- ' Employer/Business Address 4 ________________________________________________
- '
- ' Employer/Business Address 5 ________________________________________________
- '
- ' Employer Telephone Number (Inc Country code) _______________________________
- '
- ' ============================================================================
- '
- ' Date of request (Todays Date) ______________________________________________
- '
- ' NETMAIL address _________________________________________________________
- '
- ' ============================================================================
- '
- ' AGREEMENT
- ' =========
- ' I agree that I will not use GBLIB.EXE for anything other than legal and
- ' proper use, and that I will not reveal my GBLIB2 code password to anyone.
- '
- ' I understand that the infomation contained in this form will only remain
- ' confidential if I keep the above agreement.
- '
- ' I declare that the source code supplied with this form is my own work.
- '
- ' Use MakeAKey to encrypt your name, and type the resulting number
- ' here ______________ as your signature to this agreement, and the declaration.
- '
- ' NOTE: Failure to sign this form will make it null and void.
- '
- ' ============================================================================
- '
-
-
-
-
-