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Text File  |  1994-04-03  |  3KB  |  60 lines
  1. ANSIPLUS Release 3.10           Registration Form             April 1994
  2.  
  3. Required Information
  4. ====================
  5.                      Your Name: ________________________________________
  6.  
  7.                   Company Name: ________________________________________
  8.  
  9. Registered Name (if different): ________________________________________
  10.  
  11.      CompuServe/E-Mail Address: ________________________________________
  12.  
  13.         Postal Mailing Address: ________________________________________
  14.  
  15.                                 ________________________________________
  16.  
  17.                           City: ________________________________________
  18.  
  19.                 State/Province: ___________ Zip/Postal Zone: ___________
  20.  
  21.          Country (if not U.S.): _____________ Telephone: _______________
  22.  
  23.         Media Type (check one):  3.5" HD_____  5.25" HD_____
  24.  
  25.       Number of Copies Ordered: __________ With Printed Manual(Y/N)?____
  26.  
  27.     Price Per Copy (see table): __________               Each     Each
  28.                                               Quantity w/Manual DiskOnly
  29.      Subtotal (price X copies): __________    ======== ======== ========
  30.  
  31.    Sales Tax (California only): __________        1     $39.00   $25.00
  32.                                                   2      35.00    22.00
  33.    Shipping/Other Charges                         3      32.00    20.00
  34. $2.00/copy except U.S./Canada : __________        4      30.00    19.00
  35. $7.50 Zip file via CompuServe
  36. $5.00 for EuroCheque                          Call for quantity and site
  37.                          TOTAL: ==========    license pricing
  38.  
  39. Please remit check, money order    Credit Card #:_____ _____ _____ _____
  40. or Eurocheque payable in U.S.
  41. dollars only; or fill in credit    Type(Visa/MC):____ Expiration:___/___
  42. card information and sign; or call
  43. 415/924-5407 to order; or Fax          Signature:_______________________
  44. signed card order to 415/924-0258.
  45.                                          Mail to:  Kristofer Sweger
  46. Optional Information                               P.O. Box 378
  47. ====================                               Larkspur, CA 94977
  48.  
  49. How did you hear about ANSIPLUS? _______________________________________
  50.  
  51. Type of computer: ______________________  DOS version: _________________
  52.  
  53. Video controller: ______________________  Type of display: _____________
  54.  
  55. Comments: ______________________________________________________________
  56.  
  57. ________________________________________________________________________
  58.  
  59. ________________________________________________________________________
  60.