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Text File  |  1994-02-28  |  3KB  |  55 lines

  1.      Vahnzinn(tm) international ViDir(tm)/ViRes(tm) Registration Form
  2.  
  3. Mail to:   Vahnzinn international                      Phone:  215-643-6901
  4.            412 Norristown Road
  5.            Ambler, PA 19002-2737 USA                   Control # 9402110000
  6.  
  7. I have read and agree to the on-disk SLICENSE.DOC.
  8. Signature (required)_______________________________
  9. Name_______________________________________________  Date__________________
  10. Company____________________________________________________________________
  11. Address____________________________________________________________________
  12. Address____________________________________________________________________
  13. City____________________________________  State______  ZipCode_____________
  14. Country____________________________________________________________________
  15. Phones:  Home (____)___________________  Business (____)___________________
  16.                                                                         __
  17. Send freely distributable shareware version (restrictions apply).......|__|
  18.                                                                         __
  19. Send registered version without Please Register screens and room for...|__|
  20.   700 directory entries.  This version shall not be shared.  (Include fee.)
  21.  
  22. Diskette size (circle).......3.5-inch (720K).......5.25-inch (360K) (1.2MB)
  23.                                                                         __
  24. I wish to discuss a site license to reduce my cost.....................|__|
  25.  
  26. Registration Fee @ $39.00........................................__________
  27. Please send _____ additional copies @ $34.00 each................__________
  28.                                                      Subtotal....__________
  29. PA residents please add 6% sales tax.............................__________
  30. Optional Purchase Order number_____________  Total Remittance....__________
  31.    [Payment forms:  check (U.S. funds drawn on U.S. bank) or cash]
  32.  
  33. I examined version _______ (example: 1.02) of the ViDir/ViRes File 
  34.    Monitoring System for the first time on __________ (month/year)
  35.  
  36. Product comments (optional, but appreciated)_______________________________
  37. ___________________________________________________________________________
  38.  
  39. I will use this product for________________________________________________
  40. ___________________________________________________________________________
  41.  
  42. Where did you hear about this product?_____________________________________
  43. ___________________________________________________________________________
  44.  
  45.                          CREDIT CARD ORDERS ONLY 
  46.            [Contact Vahnzinn international for everything else]
  47.                         MC, Visa, Amex, or Discover
  48.                      Contact Public (software) Library
  49.                    Phone:  800-2424-PsL or 713-524-6394
  50.      7AM-7PM central U.S. time Monday-Friday; 7AM-4PM Saturday-Sunday
  51.                FAX:  713-524-6398     CompuServe:  71355,470
  52.    Credit card mail orders:  PsL, P.O.Box 35705, Houston, TX 77235-5705
  53.  
  54. Signature______________________________________________  Date______________
  55. Card Number____________________________________________  Exp Date__________