Registration form for Dutrirot by Josh Temkin at D.U. Software Co.




First and Last Name: ___________________________________________


Board or Co. Name: _____________________________________________


Type of Computer you are using Dutrirot on: ________________________

Data phone number: (___)___-____

Board or Co. Hours:_________________


Street Address:__________________________________________________

________________________________________________________________
Apt#       City          State            Zip   Country<leave blank for USA>


Version of Dutrirot:  _____


Signature:_______________________________

Make checks payable to and send this form to:
          Send $5 to 
          Josh Temkin
          1701 W. St. Mary's Rd.
          Suite A-165
          Tucson Az. 85745