XrX Logo Utility Registration

XRX Logo Utility Registration Information:

Please fill in the information below, and print this form to include with your registration:

Name:	*
Company:
Address:

City:
State / Province:
Zip / Postal Code:	*
Country:

E-Mail Address:	*

Media Format:

	While it is not required, by submitting this form, as well as printing it and including it with your cheque, you can speed up the processing of your order once we receive your payment.

Please make your Cheque or Money Order payable to 'XRX Computer Applications'. While US Funds are preferable for customers outside the US or Canada, we do accept other currencies. Please convert from the US $ amount using the exchange rate as of the date on your Cheque or Money Order. Please do NOT send Cash.

Mail your registration to:

XRX Computer Applications
P.O. Box 1542, Station M
Calgary, Alberta T2P 3B9
Canada

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