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Text File  |  1999-02-08  |  1.7 KB  |  54 lines
  1. Software Registration Form
  2. ____________________________________________________________________
  3. Name:
  4. [1]
  5. [2]
  6. [3]
  7. Phone/FAX:   [4]       [5]
  8.  
  9. Email:   [6]
  10.  
  11. Comments:   [7]  
  12.  
  13. Payment Method:
  14. [8]
  15. [9]
  16. [10]
  17. [11]
  18.  
  19. Signature (when sending via standard mail):___________________________________
  20.  
  21. Products Ordered:
  22. ([12]) PopAddress 1.0 ($20 each).................:   [13]
  23. ([14]) EZNote 1.3 ($20 each)........................:   [15]
  24. ([16]) ScrapIt Pro 5.44 ($20 each)..............:   [17]
  25. ([18]) QuickScrap 1.1 ($15 each).................:   [19]
  26. ([20]) ScrapIt Pro & QuickScrap ($30 each):   [21]
  27. ([22]) QuickPop ($10 each)...........................:   [23]
  28. ([24]) ViewFont ($5 each)..............................:   [25]
  29. ([26]) ColorFall ($10 each)...........................:   [27]
  30. ([28]) Escape! ($10 each)..............................:   [29]
  31. ([30]) SideMinder ($10 each)........................:   [31]
  32.  
  33. Quantity Discount...........:   [32]
  34. Send Latest?...(adds $5):   [33]
  35. Disk Size (800k or HD):   [34]
  36. Sales Tax (CA Only).......:   [35]
  37. Note: Sales Tax is only collected if you've requested a disk and you live in California
  38.  
  39. Total Due.........................:   [36]
  40.  
  41. [37]
  42. ____________________________________________________________________
  43. FAX, send via standard mail or email this registration form to:
  44.  
  45. John V. Holder                                                           Email addresses (AOL is preferred):
  46. 1734 "S" Street                                                        America Online:  JohnHolder@aol.com
  47. Eureka, CA  95501                                                   Internet...........:  jvholder@northcoast.com
  48. USA
  49.  
  50. FAX:  (707) 443-3813
  51.  
  52. Home Page:   http://www.northcoast.com/~jvholder
  53. (check for the latest new releases and updates!)
  54.