E-Z Access Software Ltd. Form1 P.O. 395 7/95 Calais, ME 045619-0395 Registration/Order Form For EZ-Index for NG "TRAVELER" Use this form for "ALL" U.S. money orders and checks and additional information you may send pertaining to SWREG. Name: __________________________ Company: ______________________________ Address: __________________________________ Apt:# _______________________ Street: __________________________________________________________________ City: _________________________________State: ______ Country: ____________ ZIP: _____________ Phone: _____-______-___________ Home [] Work [] Software will be shipped on a 3«HD diskette unless otherwise specified. Disk size: 5¬LD 360kb [] 5¬HD [] 3«DD [] (PLEASE CHECK [X] ONE) U.S. Funds [ ] For Spring 1984 ----- v1.84 -- $9.50 ---------------------> $ [ ] For Jan/Feb. 1990 --- v1.90 -- $7.95 ---------------------> $ SUB total $ ________ Deduct 10% if a registered user of another E-Z Access Software product. Other product? ______________________________________ $ ________ (ONLY applicable when order is placed through E-Z Access Ltd.) Registered user only: If an update what is the version # and last month indexed in your registered copy? v ____ M ____ Y ____ Updates are $6.95 -> $ ________ Shipping and Handling -------> $ 4.00 ---------- TOTAL Enclosed $_________ M D Y Date: ____/_____/_____ Signature:_________________________________ ALL Credit Card orders use form2 U.S orders send to address at top of form. In Canada SEND to: E-Z Access Software Ltd. 5185 Hwy. 127, Bocabec, Saint Andrews, NB E0G 2X0