Easy GradeBook V1.1
                            Registration Form

         Randall W. Jenkins
         1800 Viking Ave
         Orrville, Ohio  44667

                            Unit
         Quantity           Cost          Total
         ---------          ------        ------

         _________     x    $25.00   =    _______


         Disk size
         Check One:  [  ] 5.25"  or [  ] 3.5"


         Name _______________________________________

         Address ____________________________________

         City, State ________________________________

         ZIP _______________________


         Registered users will receive the latest copy of EGB.
         Thank You for your support.
         
         Please make payable to Randall Jenkins.