Internet Database Registration Form
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Please fill out the following information and send it the address below along with your check or money order (sorry no Credit Cards yet).

Prices
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$10.00 Canadian if you live in Canada.

$10.00 US if you live anywhere else.

Add $5.00 If you would like a disk with the latest version sent to you.

Fill This Out
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Name:_____________________________________________________

Company:__________________________________________________

Address:__________________________________________________

__________________________________________________________

City:_____________________________________________________

Province/State:___________________________________________

Postal/Zip Code:__________________________________________

Country:__________________________________________________

Phone:____________________________________________________

Fax:______________________________________________________

E-Mail:___________________________________________________

Would you like a receipt?_________________________________


Send It To
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John Luciani
Fusion Design
975 Warwick Court, Suite 1608
Burlington, Ontario
L7T 3Z7
Canada

Please make cheques payable to: John Luciani

My E-mail address is: bats@wchat.on.ca

Visit my Home Page: http://wchat.on.ca/web/bats/bats-m.htm