-=DEAD PAINT Reg. Form=-

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Checks or Money Orders please.

Please make checks payable to: Chung Wing Leong (my legal name)


Send it to:      Dead Paint
                 P.O. Box 2341
                 Daly City, CA  94017


To receive a registered copy, please send in $20.00 in US Funds, plus
$3.00 for postage/handling.

(Outside United State orders: Please send in $5.00 for postage/handling.
Also, please send in US currency)

Disk Size:     [ ]  5 1/4    [ ]  3 1/2


Your name: ______________________________________________________________

Address:_________________________________________________________________

City,St,Zip,Country:_____________________________________________________

Phone number (voice):____________________________________________________

BBS name: ________________________ BBS Phone number: ____________________

BBS software:______________________________ Version: ____________________



Comments:________________________________________________________________

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Signature____________________________________   Date:____________________