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/ Aminet 2 / Aminet AMIGA CDROM (1994)(Walnut Creek)[Feb 1994][W.O. 44790-1].iso / Aminet / gfx / misc / ImagDx10.lha / Registration < prev    next >
Text File  |  1993-10-16  |  2KB  |  60 lines
  1.  
  2.                               ImageDex Registration
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  4.                Send to:       Precision Imagery
  5.                               P.O. Box 20676
  6.                               Cranston, RI 02920
  7.                               USA
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  9. ------------------------------- Cut here 8< -------------------------------
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  13. ______    ImageDex Registration fee............. @ US$10.00 ea. $ _________
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  16.           SHIPPING & HANDLING  
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  18.           North America: $1;   Outside: $3                      $ _________
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  22.                                                        SUBTOTAL $ _________
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  26.          Rhode Island residents add Sales Tax......@ 7% (ouch!) $ _________
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  30.                         TOTAL (U.S. funds drawn on a U.S. bank) $ _________
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  34. Name: _____________________________________________________________________
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  36. Company (ONLY if company address): ________________________________________
  37.  
  38. Address: __________________________________________________________________
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  40.          __________________________________________________________________
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  42.          __________________________________________________________________
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  44.   Phone: _________________________
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  48. Problems, bugs, compliments, suggestions, flames: _________________________
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  50. ___________________________________________________________________________
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  52. ___________________________________________________________________________
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  54. ___________________________________________________________________________
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  56. ___________________________________________________________________________
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