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/ The PC-SIG Library 10 / The PC-Sig Library - Shareware for the IBM PC and Compatibles (PC-SIG)(Tenth Edition Disks 1-2804)(1991).iso / PC_SIGCD / 19 / 9 / DISK1991.ZIP / GB11-1.EXE / REGISTER.NOW < prev    next >
Text File  |  1990-01-02  |  4KB  |  48 lines
  1.  
  2.      ------------------------------------------------------------------------
  3.      [                           Giftbase 1.1                               ]
  4.      [                         Registration Form                            ]
  5.      [                     Make check payable to: Bob Nance                 ]
  6.      [   Date: __________                         NEWLIFE Software          ]
  7.      [                                            325 Lumpkin #2 Hedgerow   ]
  8.      [                                            Tupelo, MS  38801         ]
  9.      [                                                                      ]
  10.      [   FROM:     Name: ____________________________________________       ]
  11.      [                                                                      ]
  12.      [          Company: ____________________________________________       ]
  13.      [                                                                      ]
  14.      [          Address: ____________________________________________       ]
  15.      [   City, State,                                                       ]
  16.      [   Prov, Country, Zip: ________________________________________       ]
  17.      [                                                                      ]
  18.      [   Phone 1(____)____-______            Phone 2(____)____-______       ]
  19.      [   Circle: home bus. voice data fax    home bus. voice data fax       ]
  20.      [                                                                      ]
  21.      [   HOW DID YOU GET IT  : __________________________________           ]
  22.      [                                                                      ]
  23.      [   IF BBS, NAME & PHONE: __________________________________           ]
  24.      [                                                                      ]
  25.      [                                                                      ]
  26.      [   GIFTBASE Full Registration with printed manual    $   52.50 US     ]
  27.      [   GIFTBASE Full Registration w/ manual on diskette  $   37.50 US     ]
  28.      [      Circle one:                                                     ]
  29.      [      5 1/4:  360K   1.2M     3 1/2:  720K                            ]
  30.      [                                                                      ]
  31.      [   GIFTBASE Bare Bones Registration                  $   20.00 US     ]
  32.      [                                                                      ]
  33.      [                                                                      ]
  34.      [   Optional SECURITY (add $25.00)..................   __________      ]
  35.      [   (On full registrations(see SECURITY.DOC))                          ]
  36.      [                                                                      ]
  37.      [                            Subtotal...............   __________      ]
  38.      [                                                                      ]
  39.      [             MS residents add 6% sales tax.........   __________      ]
  40.      [                                                                      ]
  41.      [                            Total..................   __________      ]
  42.      [                                                                      ]
  43.      [                                                                      ]
  44.      [         Please DO NOT send cash.  Send check or money order.         ]
  45.      [          Your request will be filled promptly upon receipt.          ]
  46.      ------------------------------------------------------------------------
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