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Text File  |  1999-02-05  |  2KB  |  53 lines
  1.  
  2.                             *** AUS REGISTRATION FORM ***
  3.  
  4.  
  5.  
  6.           Name             ______________________________
  7.  
  8.           Company          ______________________________
  9.  
  10.           Address          ______________________________
  11.  
  12.           City/State       ______________________________
  13.  
  14.           Zip/Postal Code  ______________________________
  15.  
  16.           Country          ______________________________
  17.  
  18.           Phone            ______________________________
  19.  
  20.           EMAIL ADDRESS    ______________________________
  21.                          If you include your email address, we can
  22.                          send you the registration code immediately.
  23.  
  24.      I AM ORDERING:
  25.  
  26.         (  ) 7 in 1 Poker Patience        (AUS $23)
  27.  
  28.         
  29.      POSTAGE & PACKING
  30.      -----------------
  31.      Please add $8 (AUS) for postage and packing charges if you need
  32.      the software to be sent to you. If you already have the software
  33.      and only require the registration code, then there is no P&P charge.
  34.  
  35.      Amount Enclosed: $_________
  36.  
  37.      Make your cheque or money order payable to SHAREWARE AUSTARLIA.
  38.  
  39.      Mail payment and registration form to:    SHAREWARE AUSTRALIA
  40.                                                PO Box 1075
  41.                                                Maroubra NSW 2035
  42.                                                AUSTRALIA
  43.      Payment Method:
  44.      ___Check  ___Money Order  ___BankCard  ___VISA  ___MasterCard  ___AMEX
  45.  
  46.      Credit Card Number #____________________________   expiry ____/____
  47.  
  48.      For credit card orders:  Call (02) 9565-2339 (Order and Information)
  49.                                    (02) 9565-2362 (FAX)
  50.  
  51.      Order Online at: http://www.shareware-australia.com/ultisoft/index.htm
  52.  
  53.