Registration form for LibNcFTP

Print out the form below and mail the completed form with payment to:

Mike Gleason
6612 N 105th St.
Omaha, NE 68122
USA

Please make checks payable to Mike Gleason. Thank you!


Company/Institution: _______________________________________________________

Contact name: ______________________________________________________________

Contact's email address: ___________________________________________________

Contact's phone number: ____________________________________________________

Company/Institution address: _______________________________________________

                       City: _______________________________________________

             State/Province: ______________ Postal/ZIP code: _______________

                    Country: _______________________________________________

Quantity  Item name                                       Item price  Total
========  =============================================== ==========  ========

________  LibNcFTP source-code license                     US$199.00  ________

________  LibNcFTP object-code license for AIX             US$149.00  ________

________  LibNcFTP object-code license for BSD/OS (i586)   US$149.00  ________

________  LibNcFTP object-code license for Digital UNIX    US$149.00  ________

________  LibNcFTP object-code license for FreeBSD (i586)  US$149.00  ________

________  LibNcFTP object-code license for HP-UX           US$149.00  ________

________  LibNcFTP object-code license for IRIX            US$149.00  ________

________  LibNcFTP object-code license for Linux (i586)    US$149.00  ________

________  LibNcFTP object-code license for Linux (Sparc)   US$149.00  ________

________  LibNcFTP object-code license for Linux (Alpha)   US$149.00  ________

________  LibNcFTP object-code license for SCO (i586)      US$149.00  ________

________  LibNcFTP object-code license for Solaris (Sparc) US$149.00  ________

________  LibNcFTP object-code license for Solaris (i586)  US$149.00  ________

________  LibNcFTP object-code license for SunOS 4         US$149.00  ________

          Sub-total:                                                  ________

          Nebraska customers add 6.5% sales tax:                      ________

          TOTAL:                                                      ________