Please fill in this form (or it's copy that's included in this distribution) and e-mail or snailmail it to the address mentioned at the bottom.
+----------------------------------------------------------------+
| REGISTRATION FORM | |
+----------------------------------------------------| |
| Program : HTML-Heaven Version : 1.2 | |
+----------------------------------------------------------------+
| |
| NAME : |
| |
| ADDRESS : |
| |
| CITY : |
| |
| COUNTY : |
| |
| COUNTRY : |
| |
| SEX : _M/_F* DATE OF BIRTH : |
| (DD-MMM-YYYY) |
| PHONE-NUMBER: (Voice/Data)* |
| FAX-NUMBER : |
| |
| E-MAIL ADDR.: |
| (NETWORK) : |
| |
| AMIGA CONFIG: _ A500 _ A2000 Kick* CPU* Memory |
| _ A500+ _ A3000 _ 2.04 _ 68000 __ MB |
| _ A600 _ A3000T _ 2.1 _ 68020 |
| _ A1000 _ A4000 _ 3.0 _ 68030 Harddisk |
| _ A1200 _ A4000T _ 3.1 _ 68040 __ MB |
| _ CD32 _ Other _ Other _ 68060 |
| |
| Editor used: |
| |
| COMMENTS : |
| |
| |
| |
| |
| |
| |
| |
| By sending in this registration, I agree to abide by the terms |
| as specified in the HTML_Heaven.guide document. |
| |
| Signature: Date : |
| Place : |
| |
| * Tick the appropriate please |
| |
| ............................... |
+----------------------------------------------------------------+
| Send to : P. Kolenbrander |
| Turfveldenstraat 37 |
| NL-5632 XH EINDHOVEN |
| The NETHERLANDS |
| |
| INTERNET : paul@serena.iaehv.nl |
+----------------------------------------------------------------+
Back to the index.