Micro TECH Systems Registration form

Remit To:           Micro TECH Systems
                    555 North Spring, #39
                    Cape Girardeau Mo. 63701

Isis................................................  $ 99.95 [ ]

Payment by:  Check (U.S. bank or branch) enclosed [ ]    MC [ ]     VISA [ ]

Use Address on check [ ]  envelope [ ]   or:

Name     ___________________________________________________________________

Address  _________________________________________________________

         ___________________________________________________________________

         ___________________________________________________________________

Fidonet Software compatable Matrix address that we can use to
send your LYNX.KEY or ISIS.KEY file to for faster return processing.

 Zone ______

 Net # _______

 Node # _______

 Current Phone # for this address (___) ___- _____


HTMS Software compatable Matrix address that we can use to
send your LYNX.KEY or ISIS.KEY file to for faster return processing.

# ____________________


         ..... Following only needed for Credit Card

Work Phone  (____) __________________  Home Phone   (____)  ________________

Card #  _____________________________________________  Expires _____________

Name of Cardholder  ________________________________________________________

Signature __________________________________________________________________