Visual Beeper Registration
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Name:______________________________________________________________________

Company:___________________________________________________________________

Address:___________________________________________________________________

City/state:________________________________________________________________

Zipcode:___________________

E-Mail:____________________________________________________________________
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Pricing:
    $30 (US) = regular registration

                        Amount Included:___________________________________

                        Disk format:    3.5"            5.25"


Your Comments and Suggestions: ____________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________
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Signature:_________________________________________________________________

Send check or money order to:

        Peter F. Herbig
        6001 Eitman Ave.
        St. Louis, MO  63139

Thank you for registering!