===================== TinyPort Registration Form =========================

>>>  IMPORTANT NOTE: please use this form ONLY if there is no other way
>>>  for you to pay than by mailing a US dollar check.

>>>  Otherwise, use the form in REGISTER.TXT.
___________________________________________________________________________

Name: _________________________  Company: _________________________________

Address: __________________________________________________________________

City, State, Zip: ____________________________  Country: __________________

E-Mail: ______________________________________________  Date: _____________

TinyPort shall be registered to (please check ONE)

     _  my NAME, exactly as spelled above

     _  my COMPANY, exactly as spelled above

     _  instead to: ________________________________


TinyPort Licence (see LICENCE.TXT for details)
                      ____  copies at $75 each =           $ ______

Check fees
  (sorry, but those German banks ...)                          +$20

                         Total payment                     $ ______

___________________________________________________________________________

_ Please send me an invoice together with my registration number.
___________________________________________________________________________

Please mail this form, together with your check, to:

Manfred Keul GmbH, Landsbergstr. 16, D-50678 Koeln, Germany