--- REGISTRATION FORM ---

                            DSKDBF.EXE



First Name     :
                -------------------------------------------

Last Name      :
                -------------------------------------------

Address        :
                -------------------------------------------

City           :
                -------------------------------------------

State/Province :
                -------------------------------------------

Zip/Postal Code:
                -------------------------------------------

Phone Number   : (    )
                -------------------------------------------

Name of BBS or Vendor where DSKDBF.EXE was obtained from:


-----------------------------------------------------------


Computer       :  [ ] XT  [ ] 286  [ ] 386  [ ] 486  [ ] Other

Disk Type      :  [ ] 5 1/4     [ ] 3 1/2


Canadian residents send $15 in Canadian funds.

U.S. residents send $10 in U.S. funds.

International orders (outside of US & Canada) send $15 in U.S. funds.


Amount enclosed:
                 -------------------------------------------

Make check, money order, cashier's check payable to
Gold's Computer Solutions and mail to the address below.

                          Gold's Computer Solutions
                          RR2 Box 262
                          Lake Silkworth, PA.
                          18621-9637