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Text File  |  1997-04-06  |  1KB  |  50 lines
  1.  
  2.      Use the form below to register to use UniKEY series of 
  3. software programs for personal home use on a single computer. 
  4. Registration is for personal (home, non-business) use only.
  5.  
  6. Send to:
  7.  
  8.         UniKEY Informatica
  9.         Rua Canuto Saraiva, 3
  10.         Rio de Janeiro - RJ
  11.         20.530.000 -  BRASIL
  12.         Phone: (55)-(021)-278-0821
  13.                (55)-(021)-571-7701
  14.  
  15. ==================================================================
  16.  
  17. Product:  UniQWK v2.1 - Windows Mail Reader.
  18. Price:    US$30.00
  19.  
  20. Check/Money Order No.___________________ enclosed for $__________
  21.  
  22. OR CHARGE TO:  Master Card __________   Expiration Date__________
  23.  
  24. OR CHARGE TO:  Visa _________________   Expiration Date__________
  25.  
  26. OR CHARGE TO:  AMEX _________________   Expiration Date__________
  27.  
  28. Card Number:_____________________________________________________
  29.  
  30. Card Issued To:__________________________________________________
  31.  
  32. Signature:_______________________________________________________
  33.  
  34.  
  35. MAILING ADDRESS:
  36.  
  37. Name:____________________________________________________________
  38.  
  39. Address:_________________________________________________________
  40.  
  41. City/State/Province:_____________________________________________
  42.  
  43. Country/Postal Code:_____________________________________________
  44.  
  45. Telephone (Voice/FAX/Modem):_____________________________________
  46.  
  47. EMail____________________________________________________________
  48.  
  49.  
  50.