home *** CD-ROM | disk | FTP | other *** search
/ Pascal Super Library / Pascal Super Library (CW International)(1997).bin / COMM / TESS_5B / ORDER.FRM next >
Text File  |  1994-10-22  |  2KB  |  57 lines
  1.  
  2.  
  3.  
  4.  
  5.  
  6.  
  7.  
  8.             TesSeRact(TM) Products Order And Registration Form
  9.  
  10.  
  11.      Registration Number:     ____________________________
  12.      
  13.      Name:          ______________________________________
  14.      
  15.      Address:       ______________________________________
  16.      
  17.                     ______________________________________
  18.      
  19.      City:          ______________________________________
  20.      
  21.      State:         __________________________ Zip: ______
  22.      
  23.      Telephone:     ______________________________________
  24.      
  25.      Item                                      Quantity      Total
  26.      --------------------------------------------------------------
  27.      Registered User Upgrade ($10)_______________________|_________
  28.         (to Version 1.10)
  29.      Upgrade for Registrations after 9/15/88_____________|____0.00_
  30.      TesSeRact Registration ($25 each)___________________|_________
  31.      TesSeRact Source Code License ($25 each)____________|_________
  32.      TesSeRact Trial Disk ($10)__________________________|_________
  33.      Monthly Information NewsLetter______________________|_________
  34.         ($10 per year)
  35.      Product Identification String (Free!!)______________|____0.00_
  36.      Your ID String: ______________ Product Name: ______________
  37.      
  38.      Shipping Charges:     Upgrade Order        Normal Registration
  39.                           U.S.  :  $ 0.00         U.S.  :  $ 0.00
  40.                           Canada:  $ 5.00         Canada:  $10.00
  41.                           Europe:  $10.00         Europe:  $15.00
  42.      Overnight:  $15.00 + Normal Shipping Charge (from above)
  43.      Total Shipping Charges______________________________|_________
  44.      --------------------------------------------------------------
  45.      Total Due:                                          |_________
  46.      
  47.      Preferred Disk Size:  3.5" ____  5.25" ____
  48.      
  49.      Where did you hear about TesSeRact? __________________________
  50.      Primary Language/Compiler: ___________________________________
  51.      
  52.      Mail Completed Form to:
  53.                     TesSeRact Development Team
  54.                     1657 The Fairways
  55.                     Suite 101
  56.                     Jenkintown, PA 19046
  57.