LISTGEN 4.5x REGISTRATION FORM/INVOICE (please print or type) NAME ________________________________________________________________ COMPANY _____________________________________________________________ ADDRESS _____________________________________________________________ CITY _______________________________ STATE __________ ZIP ___________ Method of payment (U.S. Funds): ______ $20.00 Check/Money Order (Inside the U.S. and Canada) ______ $30.00 Check/Money Order (Outside the U.S. and Canada) ______ $20.00 Visa/MasterCard (Inside the U.S. and Canada) ______ $30.00 Visa/MasterCard (Outside the U.S. and Canada) Colorado residents must add the appropriate sales tax for your location. ===================================================================== Visa/MasterCard credit card users please complete: Credit Card Number: _________________________________________________ Expiration Date: ____________________________________________________ Card Holder Signature: ______________________________________________ NOTE: Credit card charges will show on your invoice as being from Professional Computer Sales, Inc. of Littleton, Colorado. ===================================================================== Send this registration form to: LISTGEN Post Office Box 620247 Littleton, Colorado 80162 United States of America Thank You!