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Text File  |  1993-04-21  |  1KB  |  36 lines
  1.                             SOURCE REGISTRATION
  2.  
  3.      Remit to:                From:
  4.  
  5.      Rick Maddy               Name:__________________________________
  6.      2727 Folsom Street       Company:_______________________________
  7.      Apt. 104                 Street:________________________________
  8.      Boulder, CO 80304        City:__________________________________
  9.      (303) 440-3682           State/Zip:_____________________________
  10.                               Phone:_________________________________
  11.      Compuserve Id:           Compuserve Id:_________________________
  12.      76460, 1601
  13.                               Name to register in:
  14.                               (Up to 40 characters)
  15.                               _______________________________________
  16.  
  17.  
  18.      Qty:                     Unit Price               Total:
  19.  
  20.      ____ SOURCE Software     $25.00 (20 + 5 S&H)      ________
  21.  
  22.  
  23.      Specify Disk Size:
  24.  
  25.      _____  5 1/4"       _____  3 1/2"
  26.  
  27.  
  28.      Current Version of Source:______________________________________
  29.  
  30.      Where Obtained:_________________________________________________
  31.  
  32.      Comments:
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