Site Registration

SlipTime Vers. 1.00 -- Site Registration Form

Company information:

Company Name: ____________________________________________
Site Address:_____________________________________________
City: _________________ State: _____________ ZIP: ________
Country (if other than US): ______________________________
Phone number: (_____)_____________________________________
Authorized employee: _____________________________________

Target INTEL CPU (check all that apply):

__ 386 or better
__ 486 or better
__ Pentium or better


Shipping and Handling (check one):


__ E-mail uuencoded file to:
_______________________________
__ 3 1/2'' DS/DD disks (Shipping and Handling: RSA: R5.00
per
                        disk, Overseas $12.00 per disk )


Payment and fees:

Fees are in Rand or in U.S. dollars, payments must made in
in checks
or money orders drawn on South African banks. Do not send
cash.
Make checks or money orders payable to:

   Peter Horn
   43 Trevor Road
   Lansdowne 7764
   Republic of South Africa


Pricing for the use of SlipTime, per site computer

    2 to 24        computers at R20 or $10 each computer:
____ x       =  ______
   more than 24 computers at R10 or $5 each computer: ____
x      = ______

Total RSA Shipping and handling (if other than E-
mail or downloading)................................. ______
Total Overseas S&H (if other than E-
mail or downloading) ................................ ______

Total:................................................______

Mail this form together with payment to:

   Peter Horn
   43 Trevor Road
   Lansdowne 7764
   Republic of South Africa