REGISTRATION FORM
                               -----------------

         PROGRAM:  LENDER'S TOOLBOX for DOS

                                                +-------------------+
         E. G. Collins                          |  DISK TYPE:       |
         2300 EDENBORN #147 II                  |  [ ] 5 1/4" 360K  |
         METAIRIE, LA   70001                   |  [ ] 5 1/4" 1.2M  |
                                                |  [ ] 3 1/2"       |
                                                +-------------------+

         Your Name:__________________________________________________


         Company:  __________________________________________________


         Address:  __________________________________________________

                   __________________________________________________


         City, State, Zip:  _________________________________________


         Daytime Phone No:  (       ) _______________________________


         ====================  PLEASE SEND ME:  =====================

         ______ copies of Lender's Toolbox @ $35.00 ea  $ ___________

                Louisiana residents add 8.5% Sales Tax  $ ___________

                Shipping & handling (each copy) @ $2.00 $ ___________

                                  TOTAL AMOUNT ENCLOSED $ ___________

         ======> PLEASE MAKE CHECKS PAYABLE TO: E. G. COLLINS <======

          << Please note:  Windows version also available for $45 >>

         Where did you hear about this program? _____________________

         Comments/Questions: ________________________________________

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              T H A N K   Y O U   F O R   R E G I S T E R I N G !