Category : A Collection of Games for DOS and Windows
Archive   : FLUX.ZIP
Filename : REGISTER.FRM

 
Output of file : REGISTER.FRM contained in archive : FLUX.ZIP

PRODUCT REGISTRATION FORM
MOONLITE SOFTWARE (TM)
(REGISTER.FRM)
Name: _________________________________

Company/Org. Name: _________________________________

Address: _________________________________

_________________________________

_________________________________

Your Telephone Number: _________________________________
(include area/country code)


Date Ordered: Month ________ Day _____ Year ______

Disk size required _____ 5 1/4 _____ 3 1/2

PRODUCT QUANTITY FEE AMOUNT
------- -------- ----------

______________________ ________ ________________

______________________ ________ ________________

______________________ ________ ________________

______________________ ________ ________________

______________________ ________ ________________

______________________ ________ ________________


TOTAL AMOUNT DUE ________________
----------------

Checks or Money orders: Make payable in U.S. currency on a U.S. bank.
Make check or money orders payable to --KIM WILLIAMSON--.

MAIL TO:

MOONLITE SOFTWARE
P.O.Box 94
Aurora, IL. 60542-0094

Where did you receive this software ? (BBS/DISK VENDOR/OTHER)
Please list which one.

_______________________________

_______________________________

_______________________________