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Text File  |  1993-05-17  |  3KB  |  60 lines
  1. ANSIPLUS Release 3.00           Registration Form               May 1993
  2.  
  3. Required Information
  4. ====================
  5.                      Your Name: ________________________________________
  6.  
  7.                   Company Name: ________________________________________
  8.  
  9. Registered Name (if different): ________________________________________
  10.  
  11.                Mailing Address: ________________________________________
  12.  
  13.                                 ________________________________________
  14.  
  15.                           City: ________________________________________
  16.  
  17.                 State/Province: __________  Zip/postal zone: ___________
  18.  
  19.          Country (if not U.S.): ________________________________________
  20.  
  21.               Telephone Number: ____________________________
  22.  
  23.         Media type (check one):  3.5" DD_____  5.25" HD_____
  24.  
  25.   Number of copies ordered: __________ Include printed manual (Y/N)?____
  26.                                       
  27. Price per copy (see table): __________                Each      Each
  28.                                           Quantity  w/Manual  Disk Only
  29.  Subtotal (price X copies): __________    --------  --------  ---------
  30.  
  31.                  Sales tax: __________        1      $39.00    $25.00
  32.                                               2       35.00     22.00
  33. Shipping ($2.00/copy outside                  3       32.00     20.00
  34.      U.S. and Canada only): __________        4       30.00     19.00
  35.  
  36.                      Total:                 Call for quantity, corporate
  37.                             ==========      and site license pricing
  38.  
  39. Please remit check/money order     Credit card #:_____ _____ _____ _____
  40. payable in U.S. dollars only; or
  41. Eurocheque in your currency at     Type(Visa/MC):____ Expiration:___/___
  42. current exchange rate; or fill in
  43. credit card information and sign;  Signature:___________________________
  44. or call (415)924-5407 to order.
  45.                                             Mail to:  Kristofer Sweger
  46. Optional Information                                  P.O. Box 378
  47. ====================                                  Larkspur, CA 94977
  48.  
  49. How did you hear about ANSIPLUS? _______________________________________
  50.  
  51. Type of computer: ______________________  DOS version: _________________
  52.  
  53. Video controller: ______________________  Type of display: _____________
  54.  
  55. Comments: ______________________________________________________________
  56.  
  57. ________________________________________________________________________
  58.  
  59. ________________________________________________________________________
  60.