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Text File  |  1993-01-31  |  2KB  |  58 lines
  1.       
  2.       Registration form for LOGISYM,                    Use ink, please print
  3.  
  4.       Name __________________________________________________________________
  5.     
  6.       Street ________________________________________________________________
  7.     
  8.       City ___________________________________ State ______ Zip _____________
  9.       
  10.       
  11.       Floppy disk type :         5.25"     [ or ]      3.5"         
  12.       
  13.                       [ Both are DSDD ]
  14.  
  15.       Printer make/model: ______________________________ (  LASER  or  DOT  )
  16.  
  17.       I / we are :
  18.       
  19.        HOBBIEST      STUDENTs      TECHNICIANs      ENGINEERs       EDUCATORs
  20.       
  21.       Obtained LOGISYM via :
  22.       
  23.       FRIEND        BBS        SHAREWARE VENDOR         SCHOOL/JOB
  24.       
  25.       Personal registration   $ 25.00    |    Instutional license    $ 250.00
  26.  
  27.       INSTITUTION  __________________________________________________________
  28.     
  29.     ADDRESS    __________________________________________________________
  30.  
  31.            __________________________________________________________
  32.  
  33.       Course Title __________________________________________________________
  34.  
  35.       Anticapated number of students per semester:  ______  ( all sections )
  36.  
  37.       Anticapated distrubution:  ______  copies       [ or ]       L A N
  38.  
  39.       Academic level at which LOGISYM is to be used ?
  40.  
  41.     High school       Certificate        Undergraduate        Graduate      
  42.  
  43.       Comments  _____________________________________________________________
  44.  
  45.       _______________________________________________________________________
  46.  
  47.       _______________________________________________________________________
  48.  
  49.       _______________________________________________________________________
  50.  
  51.     Please enclose check or money order payable to:  Andrew J. Dobson.
  52.                         
  53.                         ANDREW  J. DOBSON
  54.               Mail to :             106  W. MOWRY  ST
  55.                         CHESTER PA. 19013
  56.                           U.S.A.
  57.     
  58.