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Text File  |  1995-03-30  |  2KB  |  52 lines
  1. ****************************************************************************
  2.             Desktop Strip 1.1.2 Shareware Registration Form
  3. ****************************************************************************
  4.  
  5. Name________________________________________________________________________
  6.  
  7. Company_____________________________________________________________________
  8.  
  9. Address_____________________________________________________________________
  10.  
  11. City____________________________ State_______________________ Zip___________
  12.  
  13. Country___________________ Phone (____)______-______ Fax (____)______-______
  14.  
  15. E-Mail_______________________________________
  16. ****************************************************************************
  17. Shareware Fees
  18. --------------
  19.  1 -  5 Copies    -   US$ 20.00 per copy
  20.  6 - 20 Copies    -   US$ 17.00 per copy
  21. 21 - 50 Copies    -   US$ 14.00 per copy
  22. 50+     Copies    -   Contact Men & Mice
  23.  
  24. Number of Copies _______ @ ______ Total US$ _________
  25.  
  26. ____ Send me an invoice
  27. ****************************************************************************
  28. Method of Payment:
  29.  
  30. ____ Cash  (We prefer US$ but we also accept a equivalent amount in JPY,DEM,
  31.             FRF,GBP,BEC,NLG,CHF,CAD,ITL,ATS,PTE,ESP,IEP,DKK,NOK,SEK and FIM)
  32.  
  33. ____ Check (Please use one of the above currencies and make checks payable
  34.             to Men & Mice)
  35.  
  36. ____ Visa ____Mastercard ____Amex #_________________________ Exp Date ______
  37.  
  38. Signature_________________________________________ Date_____________________
  39.  
  40. Mail to:  Men & Mice
  41.           P.O. Box 7238
  42.           127 Reykjavik
  43.           ICELAND
  44.  
  45. E-mail:   AOL: MenAndMice
  46.           CompuServe: 100045,2425
  47.           Internet: registrations@menandmice.is
  48.  
  49. Fax:      +354-569-4991
  50.  
  51.                      *** THANK YOU FOR SUPPORTING SHAREWARE ***
  52.