Bricklayer for Windows v1.7 Registration Form Vanilla-Extract Software ================================================================== [Name] Title _______ Last Name ____________________ First Name ____________________ Initial __ ================================================================== [Address] if USA: Address _______________________________________________ City _______________________________________________ State, Zip __ _____-____ if Outside USA: Address __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ Country ____________________________ email address _____________________ Would you like to be notified about new products/releases via email ? [ ] Yes [ ] No ================================================================== [Additional Information] Where did you find Bricklayer (ftp/internet, online service, BBS, friend, etc.) ? What Hardware and OS are you using ? Any Comments/Suggestions regarding Bricklayer ? ================================================================== Pricing Information ================================================================== Description Qty Unit Price Total ------------------------------------------------------------------ Single-User Registration $10.00 .................................................................. Additional Single-User License $ 5.00 .................................................................. 10-machine site license $50.00 25-machine site license $100.00 Unlimited site license $150.00 .................................................................. Latest Version on disk $ 3.00* .................................................................. Bonus Disk Set of Music and Graphics $10.00* (includes latest version) .................................................................. Total Enclosed: ------------------------------------------------------------------ * Only registered users or users registering with this order are eligible to purchase disk sets. Price includes media and shipping charges. ================================================================== ---------------8<---------------8<-----------------8<------------- Thank you for registering Bricklayer for Windows! Please send US$10 for each copy of Bricklayer to be registered to: Yevgeny Gurevich 129 Franklin Street #112 Cambridge, MA 02139-4100 You may alternatively register via CompuServe's Shareware Registration: GO SWREG The CompuServe SWREG id for Bricklayer is #4732