FAMILY-IV REGISTRATION FORM

  To:    Jim Wanderscheid                           Date:__________________
         4 rue Jean Monnet
         94510 La Queue-en-Brie
         France



  From: (PLEASE PRINT CLEARLY)

         Name:     ________________________________________________________

         Address:  ________________________________________________________

         Zip Code: ___________________  City:  ____________________________

         Country:  ___________________  State: ____________________________



  Product: _____ Family-IV Software Pack (latest release)        FRF 85,00

           _____ Shipping and Handling                           FRF 15,00

                                                          Total: FRF  _____


  All prices in French Francs (guaranteed through 1994). We are unable to
  accept Credit Cards or Eurocheques. International orders: Please remit
  cash or bank check in French Francs payable to J.P.Wanderscheid at a 
  French bank.

  Disk format will be 3,5 inch 1,44MB, unless specified.

                 

  I learned about Family-IV from:
   __            __                    __                   __
  |__| Friend   |__| Genealogy Club   |__| Computer Club   |__| CompuServe

  Other ___________________________________________________________________


  I use: Computer:         ________________________________________________

         Operating System: ________________________________________________

         Genealogy System: ________________________________________________