----------------------------------------------------------- IconDar ----------------------------------------------------------- REGISTRATION FORM Please print and return this form with your payment by check for the amount indicated below to: LIOR MESSINGER P.O. Box 23730 TEL AVIV 61231 ISRAEL You will receive a registered version 1.2 of the program on diskette. Amount Registration Fee: ---------------------------------------------- [ ] IconDar $10.00 [ ] 3-1/2" diskette(s) $1.00 Total Enclosed $_______ Name ________________________________________________ Company (if applicable) _____________________________ Address _____________________________________________ City __________________________________ State _______ Zip __________________ Phone ________________________ PC/CPU/Speed ________________________________________ Sound Card? [ ] No [ ] Yes : ______________________ Display? [ ]VGA [ ]SVGA [ ] Other: ________________ Where Obtained? _____________________________________ Suggestions/Comments ________________________________ _____________________________________________________