Registration Form


  Send to: MicroMedia, 9633 41st S.W.
  Seattle,  WA 98136

  YES, I want to be a registered user of the LottoPro
  and be placed on the preferred customer list
  for all future MicroMedia releases!

  I am enclosing $29.95   Please send me the latest
  version of LottoPro.  Check, Money Order, Visa or

  Mastercard. (MCard/Visa # _______________________

  Expiration Date: __________)


  Name ______________________________________________

  Address: __________________________________________

  City:    __________________________________________

  State:   __________    Zip Code ___________________
  
  Phone Number: ______________________________________

  Computer Name ______________________________________