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                                                  Jack in the Box Computing
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                       -= S U P P O R T   F O R M =-

   Product    : GUIMO

   Name       : 
   Address    : 
   City       : 
   State      : 
   Zip Code   : 
   Country    : 
   Phone      : 
   E-mail     : 
   Machine    : [ ]486  [ ]Pentium   [ ]Other:______
   Clock      : ___Mhz
   RAM Memory : [ ]8Mb  [ ]12Mb      [ ]16Mb            [ ]more-than-16Mb
   Op.System  : [ ]DOS  [ ]Windows-3 [ ]Windows-95      [ ]Windows-NT
   SoundCard  : [ ]SoundBlaster-pro  [ ]SoundBlaster16  [ ]SoundBlaster-AWE32

   Problem    : _____________________________________________________________
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   Address: Ave Cairu 1208/201
            Porto Alegre - Brazil
            90230 030
   Fax    : +55 (51)343-3300
   E-mail : support@jackbox.com
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