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/ L' Effet Pommier 2 / L'Effet Pommier - Volume 02.iso / Réflexion / guy smiley 1.0 / Guy Smiley Registration Form < prev    next >
Text File  |  1995-04-09  |  958b  |  39 lines
  1. Guy Smiley vs. the Monsters
  2. __________________________________________________
  3. version 1.0
  4.  
  5. Registration Form
  6.  
  7. Complete this form and mail it along with your fee ($10.00 US) to the address below.
  8. Please make checks payable to Reid Priedhorsky.
  9.  
  10. Reid Priedhorsky
  11. 2123-A 45th St.
  12. Los Alamos, NM 87544
  13. USA
  14.  
  15. Last Name: ________________________________________
  16.  
  17. First Name: _______________________________________
  18.  
  19. Organization: ______________________________________
  20.  
  21. Address: __________________________________________
  22.  
  23. City: ____________________________________________
  24.  
  25. State: ____   Zip Code: _______________
  26.  
  27. Email Address: _____________________________________
  28.  
  29. Computer Type: _____________________________________
  30.  
  31. Comments: ________________________________________
  32.  
  33. _________________________________________________
  34.  
  35. _________________________________________________
  36.  
  37. _________________________________________________
  38.  
  39. Thank you for supporting shareware!