REGISTRATION FOR PAGEBUILDER
Product ID: 8542
Program Name: PageBuilder
Operating System: Win95/98
Please be sure your email address is correct! This is how you will receive your registration confirmation.
HOTMAIL email addresses, and other email forwarding addresses are NOT accepted. Compuserve users please use a period (.) instead of a comma (,) 1234.567 not 1234,567.
Email Address: _________________________________________________________
Name (as it appears on credit card): _______________________________________
Company Name (optional): _______________________________________________
Address (exactly as it appears on your statement):
Address (cont): _________________________________________________________
Postal Code: _________________________
Phone Number: _______________________
Credit Card Type: Visa / MasterCard / American Express / Discover (Novus)
Card Number: _________________________
Card Expiration Date: ___________________
By signing here you agree to pay the indicated fees billed by RegSoft.com to your credit card account for this order. You also agree to pay any legal fees incurred by RegSoft.com for the recovery of their costs in the event you dispute their charges.
Please tick here ____ if you wish to be billed an extra $24.95 ($19.95 + $5.00 S&H) for the RegSoft.com Shareware CD Volume 1.
Your card will be charged as RegSoft.com.
When completed, please mail this form to:
10820 Abbotts Bridge Road
Duluth, GA 30097
or fax to: