+------------------------------------------------------------------------+ | 4A Launch 1.00 Registration Form | +------------------------------------------------------------------------+ | | | NAME:_________________________________________________________________ | | | | COMPANY:______________________________________________________________ | | | | ADDRESS:______________________________________________________________ | | | | CITY:______________________________ STATE:_______ ZIP:________________ | | | | HOME PHONE NUMBER:____________________________________________________ | | | | BUSINESS PHONE NUMBER:__________________ FAX NUMBER:__________________ | | | +------------------------------------------------------------------------+ | | | NUMBER OF USERS PRICE PER USER | | ----------------------------------------------------- -------------- | | 1 User Individual License $15.00 | | 2 To 10 User Network Or Site License $14.25 | | 11 To 25 User Network Or Site License $13.50 | | 26 To 100 User Network Or Site License $12.00 | | 101 Or More User Network Or Site License $11.25 | | | | | | NUMBER OF USERS MULTIPLIED BY THE PRICE PER USER: $ ________ | | | | NY STATE RESIDENTS ADD SALES TAX: $ ________ | | | | | | GRAND TOTAL: $ ________ | | | +------------------------------------------------------------------------+ | TO REGISTER THIS PROGRAM, MAIL YOUR PAYMENT & THIS FORM TO: | | 4A Software | | 562 Buxton Avenue | | West Hempstead, New York 11552 | | *** Please make all checks or money orders out to DAVID M. BISHOP *** | +------------------------------------------------------------------------+ +------------------------------------------------------------------------+ | If you would like to find out about our other shareware offers, send | | this form to: | | 4A Software | | 562 Buxton Avenue | | West Hempstead, New York 11552 | | *** Please make all checks or money orders out to DAVID M. BISHOP *** | +------------------------------------------------------------------------+ | | | NAME:_________________________________________________________________ | | | | COMPANY:______________________________________________________________ | | | | ADDRESS:______________________________________________________________ | | | | CITY:______________________________ STATE:_______ ZIP:________________ | | | | HOME PHONE NUMBER:____________________________________________________ | | | | BUSINESS PHONE NUMBER:__________________ FAX NUMBER:__________________ | | | +------------------------------------------------------------------------+ | | | SINGLE USER | | ITEM AVAILABLE QUANTITY PRICE* TOTAL | | ------------------------------- --------- -------- ----- ----- | | | | PRODUCT INFORMATION PACKAGE NOW ________ FREE _____ | | | | West Hempstead Country Club NOW ________ FREE _____ | | | | Malverne Country Club NOW ________ FREE _____ | | | | Scribble 1.00 NOW ________ FREE _____ | | | | 4A Calc 3.00 NOW ________ $ 5.00 _____ | | | | 4A Draw 2.00 NOW ________ $ 5.00 _____ | | | | 4A Draw Upgrade From Scribble NOW ________ $ 2.50 _____ | | | | Universal Lottery Picker 1.00 NOW ________ $ 7.50 _____ | | | | 4A Launch 1.00 NOW ________ $15.00 _____ | | | | 4A Basketball 2.70 01/93 ________ $12.50 _____ | | | | | | TOTAL PRICE: $ ________ | | | | NY STATE RESIDENTS ADD SALES TAX: $ ________ | | | | SHIPPING & HANDLING: $ ________ | | ($2.50 IN USA, $5.00 IN NORTH AMERICA, $10.00 ELSEWHERE) | | | | GRAND TOTAL: $ ________ | | | +------------------------------------------------------------------------+ | * The prices listed under SINGLE USER PRICE are for a single user | | individual license. Please write for multi-user site license prices.| +------------------------------------------------------------------------+