Xerix Registration Form

Xerix Registration Form

Free Registration

Name: __________ ______ ____ ___________________

Address: ____ 434u2016e __________ ______ ____ _______________

__________ ______ ____ ___________________

City/Suburb/Province: __________ ______ ____ ______

State: __________ ______ ____ _____ _______ ______ ______

Zip/Post code: _________________

Please fill out the following, marking all that apply.

Processor: ___80286 (AT) Display: ___MCGA (PS/2)

___80386SX ___VGA

___80386 ___Super VGA

___i486

Sound card/module: Floppy Disk drive:

___none ___5.25 inch

___Adlib ___3.5 inch

___Sound Blaster

___Adlib Gold DOS: ___MS-DOS ver:__

___Sound Blaster Pro ___DR-DOS ver:__

___Pro Audio Spectrum ___MS Windows

___Roland MT-32/LAPC-1 or compatible

___other: ___________

Other Devices:

___CD-ROM

___Modem

___2-button Mouse

___3-button Mouse

___Joystick

Comments/Suggestions: __________ ______ ____ ______

__________ ______ ____ __________________

__________ ______ ____ __________________

Please post to:

Brendan Reville,

PO Box 304, Milsons Point NSW 2061, Australia.

Thank you for returning this registration form.