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  1.                The Programmers Toolbox Reistration Form
  2.  
  3. ====================================================================
  4. =                                                                  =
  5. =                            Silicon Systems                       =
  6. =                          5217 Millsprings Dr.                    =
  7. =                         Arlington, TX  76017                     =
  8. ====================================================================
  9. =                                                                  =
  10. =   Product                       Qty        Price         Total   =
  11. =-------------------------------------------------------------------
  12. =                                                                  =
  13. = The Programmers Toolbox         ___       $15.00        $_______ =
  14. =                                                                  =
  15. =                                                                  =
  16. = Sales Tax (Texas Residents Only)           7.5%         $_______ =
  17. =                                                                  =
  18. =                                                                  =
  19. =                                            Total :      $_______ =
  20. =                                                                  =
  21. =                                                                  =
  22. =-------------------------------------------------------------------
  23. =                                                                  =
  24. =   Name     : ___________________________                         =
  25. =                                                                  =
  26. =   Address  : _________________________________________           =
  27. =                                                                  =
  28. =   City     : ______________    State : ___   ZIP : ________      =
  29. =                                                                  =
  30. =-------------------------------------------------------------------
  31. = * Make Money Order or Personal Check payable to Silicon Systems  =
  32. ====================================================================