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Text File  |  1996-09-26  |  2KB  |  37 lines
  1. ------------------------------------------------------------------
  2. | Registration form/Registrierformular/Formulaire d'utilisateur  |
  3. | -------------------------------------------------------------- |
  4. |                        for/für/pour                            |
  5. |                        ------------                            |
  6. |                            MachV                               |
  7. |                            -----                               |
  8. |                                                                |
  9. | First Name/Vorname/Prénom:____________________________________ |
  10. |                                                                |
  11. |                                                                |
  12. | Last Name/Nachnahme/Nom:______________________________________ |
  13. |                                                                |
  14. |                                                                |
  15. | Address/Adresse:______________________________________________ |
  16. |                                                                |
  17. |                                                                |
  18. | City,Zip/PLZ&Ort/CodePostal&Ville:____________________________ |
  19. |                                                                |
  20. |                                   ____________________________ |
  21. |                                                                |
  22. | Country/Land/Pays:____________________________________________ |
  23. |                                                                |
  24. |                                                                |
  25. | Amount Enclosed/Montant inclus :$________                      |
  26. | (Make check payable to Brian Moats)                            |
  27. |________________________________________________________________|
  28.  
  29.                            Mail To:
  30.                               Envoyez à :
  31.  
  32.                            Brian Moats
  33.                            Polyglot Software
  34.                            884 W Melrose Ln.
  35.                            Boise, ID  83706
  36.                            USA
  37.