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License request for PBIcon
Copyright (c) 1990 by Leonard A. Gray



PBIcon is licensed on a user/machine basis. The license grants the user
the right to install and use the software on one or more computers, so
long as the number of licenses purchased is at least equal to the number
of persons using the software or the number of machines it is installed
upon, whichever is less. The license(s) will be valid for the current and
all future shareware releases of PBIcon.


Please include the following information:


_______________________________________
(Name or Company)

_______________________________________
(Street)

_______________________________________
(City) (State/Prov) (ZIP)

_______________________________________
(Country)

_______________________________________
(Phone)


Users Charge Total

_____ x $10.00 _______



Mail check or money order to:

Impact Software
2321 S. Magnolia Ave. #9D
Ontario, CA 91762


Thank you for supporting the shareware software concept and
encouraging the future development of Windows shareware!


Windows is a trademark of Microsoft Corporation


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CUSTOMER INFORMATION



The following information will help us to serve you best as a customer:



1. Processor: ___ 8086 ___ 286 ___ 386 ___ 386SX ___ 486



2. Video mode: ___ Mono ___ CGA ___ EGA ___ VGA ___ Hercules

SuperVGA: ___ (800x600) ___ (1024x768) ___ 8514

___ Other:___________________



3. Printer: _____________________________ ___ Dot matrix ___ Laser
(Make and model)
___ Color



4. Found PBIcon: ___ Bulletin Board __________________ _____________
(Name of BBS) Phone #

___ Software Catalog _______________________________
(Name of catalog)

___ Other: __________________________________________




5. If you would like to see future versions of PBIcon uploaded to your
local bulletin board, please include the following information:

Your current version: __________ (Select 'About...' from 'File' menu)

Board Name: __________________________ Location:______________________


Phone #: _________________ ___ 1200 ___ 2400 ___ 9600

Phone #: _________________ ___ 1200 ___ 2400 ___ 9600


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