home *** CD-ROM | disk | FTP | other *** search
/ L' Effet Pommier 3 / L'Effet Pommier - Volume 03.iso / Utilitaires System / Quick Pop (2.0) / Registration (open me!) / Registration (open me!).rsrc / TEXT_1132_Credit Card Order form (email).txt < prev    next >
Text File  |  1995-10-03  |  799b  |  37 lines
  1. Product:  QuickPop 2.0
  2. ____________________________________________________________________
  3.  
  4. Name:
  5. [1]
  6. [2]
  7. [3]
  8. Phone/FAX:   [4]       [5]
  9.  
  10. Email:   [6]
  11.  
  12. Comments:   [7]  
  13.  
  14. Payment Method:
  15. [8]
  16. [9]
  17. [10]
  18. [11]
  19.  
  20. Price per copy..........:   $10.00
  21. Number of copies........:   [12]
  22. Quantity Discount.......:   [13]
  23. Send Latest?............:   [14]
  24. Sales Tax (CA Only).....:   [15]
  25.  
  26. Total Due...............:   [16]
  27.  
  28. [17]
  29. ____________________________________________________________________
  30. Email this registration form to:
  31.  
  32. John V. Holder                   Email addresses (AOL is preferred):
  33. 2862 Lowell Street               America Online:  JohnHolder
  34. Eureka, CA  95501-4315           Internet......:  JohnHolder@aol.com
  35.                                  CompuServe....:  75040,1126
  36. FAX:  (707) 443-3813
  37.