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- ========Visual Modem Registration ============== Version 3.5 ===========
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- Remit to:
- Mark Findlay
- 8717 31st Ave NW
- Seattle, WA 98117
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- Please send:
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- _____ 1 Copy Visual Modem . . . . . . . . . . . .ea $39.95 = $ _______
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- _____ 2 - 10 Copies Visual Modem . . . . . . . . .ea $34.95 = $ _______
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- _____ 11 or more Copies Visual Modem . . . . . . .ea $29.95 = $ _______
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- Subtotal = $ _______
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- Please add 15% if check is not U.S. currency . . . . . $ _______
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- Total = $ _______
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- Name: _______________________________________________________________
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- Company: _______________________________________________________________
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- Address: _______________________________________________________________
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- _______________________________________________________________
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