Registration form for UZPower from UZful Software
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        Send to:
                UZful Software, Inc.
                PO Box 2089
                Merrimack, NH 03054-2089
                USA


        Individual Registered Version      Qty ____ @ $5.00       $_________


                                                          Total   $_________


        Payment method: (  ) Check/money order  (  ) PO # ____________________
        Note: All payments must be in U.S. funds, drawn on a U.S. bank


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        Name      Last                          First

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        Title                                   Company Name

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        Street Address                          City

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        State/Province/Region                   ZIP/Postal code

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        Country                                 E-mail address

        Where did you get your copy of the program? __________________________


        What brand and model of laptop do you use? ___________________________

        Please give us any feedback (comments, problems, wishes) below.
        Thank you.


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