VideoBASE v1.0 for Windows Registration Form

METHODS OF PAYMENT:

   1. Cash
   2. Check
   3. Postal Money Order

UPGRADES:

For information on upgrade policy, see the section entitled UPGRADES
in the VideoBASE online help system.


SEND ORDER TO:

Dale W. Eckert
6527 Gillmore Drive
Regina, Saskatchewan
Canada
S4X 3Z3


Prices guaranteed through December 1993.

VideoBASE single copy: Quantity _____ @ $29.95 each = _________
Shipping and Handling:                  $ 5.00      =     $5.00
                                      Total Payment = _________

Name: ________________________________  Date: _________________
Address: _____________________________
City:    _____________________________
State or Province: ___________________
Country: __________
Day Phone: _____________________ Evening Phone: _______________

Electronic Mail Address: ______________________________________
How did you hear about VideoBASE? _____________________________

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