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Text File  |  1999-02-08  |  1.4 KB  |  55 lines
  1. Software Registration Form
  2. ____________________________________________________________________
  3.  
  4. Name:
  5. [1]
  6. [2]
  7. [3]
  8. Phone/FAX:   [4]       [5]
  9.  
  10. Email:   [6]
  11.  
  12. Comments:   [7]  
  13.  
  14. Payment Method:
  15. [8]
  16. [9]
  17. [10]
  18. [11]
  19.  
  20. Products Ordered:
  21. ([12]) PopAddress 1.0 ($20 each)..........:   [13]
  22. ([14]) EZNote 1.3 ($20 each)..............:   [15]
  23. ([16]) ScrapIt Pro 5.44 ($20 each)........:   [17]
  24. ([18]) QuickScrap 1.1 ($15 each)..........:   [19]
  25. ([20]) ScrapIt Pro & QuickScrap ($30 each):   [21]
  26. ([22]) QuickPop ($10 each)................:   [23]
  27. ([24]) ViewFont ($5 each).................:   [25]
  28. ([26]) ColorFall ($10 each)...............:   [27]
  29. ([28]) Escape! ($10 each).................:   [29]
  30. ([30]) SideMinder ($10 each)..............:   [31]
  31.  
  32. Quantity Discount.......:   [32]
  33. Send Latest?...(adds $5):   [33]
  34. Disk Size (800k or HD)..:   [34]
  35. Sales Tax (CA Only).....:   [35]
  36. Note: Sales Tax is only
  37. collected if you've
  38. requested a disk and
  39. you live in California
  40.  
  41. Total Due...............:   [36]
  42.  
  43. [37]
  44. ____________________________________________________________________
  45. Email this registration form to:
  46.  
  47. John V. Holder                           Email addresses (AOL is preferred):
  48. 1734 "S" Street                          America Online:  JohnHolder@aol.com
  49. Eureka, CA  95501                        Internet......:  jvholder@northcoast.com
  50. USA
  51.  
  52. FAX:  (707) 443-3813
  53.  
  54. Home Page:   http://www.northcoast.com/~jvholder
  55. (check for the latest new releases and updates!)