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Text File  |  1994-07-21  |  861b  |  37 lines
  1.  
  2.  
  3.                            REGISTRATION FORM
  4.                             RW2VB ver. 1.0
  5.  
  6.  
  7.     NAME/CONTACT_______________________________________________
  8.  
  9.     STREET_____________________________________________________
  10.  
  11.     CITY_______________________________________________________
  12.  
  13.     STATE______________________________ ZIP____________________
  14.  
  15.     TELEPHONE NUMBER___________________________________________
  16.  
  17.     E-MAIL_____________________________________________________
  18.  
  19.  
  20.  
  21.     Qty    Item                          Unit Price       Total
  22.  
  23.     ____   RW2VB v. 1.0 registration         $20.00   _________
  24.  
  25.  
  26.  
  27.  
  28.      ___________________________________________________________
  29.  
  30.      Make checks payable to: Bruno Paris 
  31.  
  32.      Mail to:
  33.           Bruno Paris
  34.           K. Jelene 6
  35.           41000 Zagreb
  36.           Croatia
  37.