ErgoFile Registration Form  


Name:		  __________________________________________________

Company:	  __________________________________________________

Mailing Address:  __________________________________________________

City, State, Zip: __________________________________________________

e-mail Address:	  __________________________________________________


How did you learn about ErgoFile?

____________________________________________________________________


Comments, Suggestions:

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________


Disk Size:   ( ) 3.5" (1.44 M)    ( ) 5.25" (1.2 M)


 ______________|___Qty___X__Price Each___=___Total__
|ErgoFile      |         |  $29.95 U.S.  | $        |
|______________|_________|_______________|__________|
                         | Shipping on   |          |
                         | non-U.S.      | $ + 6.00 |
                         | orders only   |          |
                         |_______________|__________|
                         | =    Total    | $        |
                         |_______________|__________|


Please send this form along with a check or 
money order for the proper amount to:

	Ergosoft
	P.O. Box 5433
	Herndon, VA 22070
        United States of America