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/ Gold Medal Software 3 / Gold Medal Software - Volume 3 (Gold Medal) (1994).iso / archive / zipw20.arj / ZIPFUGUE.RE_ / ZIPFUGUE.RE
Text File  |  1994-04-22  |  4KB  |  59 lines
  1. .tc ZIP Fugue Registration Form  . . . . . . . . . . . . . . . . . . #
  2. ┌──────────────────────────────────────────────────────────────────────┐
  3. │ Return to:     Fugue Software           Voice +61 7 824 2843         │
  4. │                P.O. Box 425              Fax  +61 7 824 2843 (same)  │
  5. │                CAPALABA  QLD 4157       Compuserve 100036,311        │
  6. │                AUSTRALIA                                             │
  7. │                                                                      │
  8. │ Name ______________________________________________________________  │
  9. │                                                                      │
  10. │ Company ___________________________________________________________  │
  11. │                                                                      │
  12. │ Address ___________________________________________________________  │
  13. │                                                                      │
  14. │         ___________________________________________________________  │
  15. │                                                                      │
  16. │ Diskette size:     ____ 5.25" acceptable       ____ 3.5" required    │
  17. │                                                                      │
  18. │                    [ ]  please send high density disks only          │
  19. ├──────────────────────────────────────────────────────────────────────┤
  20. │ Please send me a registered copy of ZIP Fugue (with printed manual)  │
  21. │                                                                      │
  22. │   Check here for information on:    [__] Multi-system Licenses       │
  23. │                                     [__] Reseller Pricing            │
  24. │                                     [__] Catalog of products         │
  25. │                                                                      │
  26. │  Where did you hear about ZIP Fugue? _____________________________   │
  27. │                                                                      │
  28. │  __________________________________________________________________  │
  29. │                                                                      │
  30. │  I agree to abide by the ZIP Fugue License agreement.                │
  31. │                                                                      │
  32. │   Signed                                                             │
  33. ├──────────────────────────────────────────────────────────────────────┤
  34. │                                               Quantity   Price       │
  35. │ Zip Fugue Complete package (DOS & Windows)                           │
  36. │     ( AUD $35    USD $25   UK £15 )           ________   __________  │
  37. │ Zip Fugue for DOS only                                               │
  38. │     ( AUD $20    USD $14   UK £10 )           ________   __________  │
  39. │ Zip Fugue for Windows only                                           │
  40. │     ( AUD $20    USD $14   UK £10 )           ________   __________  │
  41. │                                                                      │
  42. │ Shipping charges, per copy:                              __________  │
  43. │                                                                      │
  44. │ Postage to:                    Total enclosed:           __________  │
  45. │ Australia       $4 AUD                                               │
  46. │ New Zealand     $5 AUD    $7 NZD                                     │
  47. │ USA             $8 AUD    $5 USD                                     │
  48. │ UK & Europe    $12 AUD    $8 USD     £5  UK                          │
  49. │                    I wish to pay by:                                 │
  50. │     [ ]   Visacard                     [ ]   Cheque                  │
  51. │     [ ]   Mastercard                   [ ]   Bankcard (Australia)    │
  52. │                                                                      │
  53. │Credit Card:  __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __   │
  54. │                                                                      │
  55. │ Expiry Date:  ___/___ Name: _________________________________________│
  56. │                                                                      │
  57. │ Signature :                                                          │
  58. └──────────────────────────────────────────────────────────────────────┘
  59.