Apteryx Lisp 1.x Registration Form

TO:

Apteryx Lisp Ltd
PO Box 12280
Thorndon
Wellington
New Zealand  

email address: Compuserve 100241,1154


FROM:


Name: ____________________________

Company: _________________________

Address: _________________________

         _________________________

         _________________________

         _________________________


Today's date: ______________


(Note - all prices and amounts are in New Zealand dollars.)

Single Licence:   ___ at NZ$40 each                             _______

Educational Licence: for __ computers at
                     NZ$30 per institution + $10 per computer   _______

Bulk Student Licences: for ____ students at NZ$10 each               _______
       (supply names and addresses on separate form)

New Zealand purchasers only, add 12.5 % GST to total            _______


Payment details

_ I enclose a cheque or bank draft for NZ$ _____  
       (Personal cheques accepted subject to clearance.)


           or 


_ Please bill my   __ Mastercard or  __ Visa to the amount of NZ$ _____

Credit Card No: _ _ _ _  _ _ _ _  _ _ _ _  _ _ _ _

Expiry Date: __________

Card Holder's Name: ________________________

Card Holder's Signature: _______________________________

Card Holder's address if different from delivery address:

  _______________________________________________________________________
 
On receipt and clearance of payment, Apteryx Lisp Ltd will send the
user a Registration Certificate and receipt.

Note: Educational licences permit use of Apteryx Lisp 1.x on the
specified number of computers in the institution. Where it is
desired that students be able to use the program on their own computers,
student licences may be acquired at NZ$10 each student.

Requirements for ordering Student Licences are - 

All members of the course must be required to purchase such a licence.
The course holder must supply payment and list of students to be licenced
in bulk to Apteryx Lisp Ltd. Apteryx Lisp Ltd, will then send the
student licences to the course holder, who can then distribute them to 
the students.

--------------------------------------------------------------------


Mail this form with payment to

   Apteryx Lisp Ltd
   PO Box 12280
   Thorndon
   Wellington
   New Zealand