PageMate for Windows v1.2 Registration Form
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R.J. Matter & Assocs.
P.O. Box 9042
Highland, IN  46322-9042  USA
24 hr. Tel./Fax: (219) 845-5247
E-mail: 71021.2654@compuserve.com

You may register by phone, fax, mail, or e-mail.
Visa, MasterCard, Discover, checks, and money orders payable
in US dollars are accepted.  Sorry, no C.O.D's.

Purchase orders (net 30 days) are accepted from government
and educational institutions.  Due to the extra work involved
in processing purchase orders you are encouraged to use a
credit card, petty cash, or an expense account when possible
for small orders. 

Orders are shipped on 3.5" high density (1.44Mb) disks on the
same day received.


PageMate Single Copy  ____    copies at $39 each = ______

PageMate Site License
  2 to   9 computers: ____ computers at $32 each = ______
 10 to  24 computers: ____ computers at $27 each = ______
 25 to  49 computers: ____ computers at $23 each = ______
 50 to  99 computers: ____ computers at $20 each = ______
100 to 199 computers: ____ computers at $18 each = ______

A site license for PageMate entitles an organization to
receive one copy of the distribution package and duplicate
the distribution disk for the specified number of copies.

[ ]Check/Money Order (payable to R.J. MATTER)

[ ]Purchase Order (attach copy of P.O.)

[ ]Visa  [ ]MasterCard  [ ]Discover

Card Acct. # ________________________________________
   
Exp. Date ___/___  Signature ________________________


Bill To:

Name ________________________________________________

Company _____________________________________________

Address _____________________________________________

City/State/Zip ______________________________________

Country _____________________________________________

Day Phone __________________  Fax ___________________

Eve Phone __________________  Fax ___________________

E-Mail address ______________________________________


Ship To: (if different from above)

Name ________________________________________________

Company _____________________________________________

Address _____________________________________________

City/State/Zip ______________________________________

Country _____________________________________________

Day Phone __________________  Fax ___________________

Eve Phone __________________  Fax ___________________

E-Mail address ______________________________________


How did you hear about PageMate? ____________________

_____________________________________________________


Comments ____________________________________________

_____________________________________________________


Thank you for your support!


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