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RegForm.txt
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1999-04-07
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2KB
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56 lines
To
Pedro Luis Mieza
Passeig Pere III, 45, 8, 3
08240 Manresa
Barcelona
SPAIN
I want to become a registred user of the MetalWEB designer:
Name
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Address
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Country
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E-Mail
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Comment
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Machine
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I am sending the shareware fee as (please mark as appropriate)
[ ] DM 40,- / US$ 25 ,- /3000 Ptas in cash, included with
this letter
[ ] Eurocheque over 3000 Ptas -, included with this letter
[ ] Postal Money Order over 3000 Ptas,-, coming separately
[ ] Money transfer of (DM 40, US$ 25, 3000Ptas or 20 Euros)
+ (Bank Transfer Costs) to this account:
Owner : Pedro-Luis Mieza Suarez
Bank : Caixa de Manresa
Bank Code : 2041 0119 88
Acct.No. : 000.000174.9
(Please indicate your name on the transfer form!, I must receive
the complete 25$, 40DM, 3000 Ptas or 20 Euros, you must pay extra
transfer costs, and tell me your money transfer by email)
_____________________ __________________________________________
(Date) (Signature)