ALTAIR Registration Form
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Please fully complete this form and return via the methods outined below

Full Name ________________________ Date __________ Phone ______________

Company/BBS ______________________________________ BBS no _____________

BBS Software __________________________________________________________

Street Address ______________________________________ Fax _____________
(For printed documentation if necessary)

City _____________________ St _____ Zip ____________ Country __________

FidoNet Node number _______________ Othernet __________________________

Internet Address ______________________________________________________

Operating System (Check One)    [ ] Windows 95  [ ] Windows NT

Delivery Method  (Check One)    [ ] Fidonet     [ ] MSN     [ ] US Mail
                                                                (diskette)

Pricing (See ALTAIR.WRI for details)                Price   Qty  Cost
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Non Commercial Registration                         $  25  ____  ____
Commercial Registration                             $  50  ____  ____

Printed Documentation                               $  10  ____  ____

Shipping and Handling (if delivery via US Mail)     $   5  ____  ____

                                                     TOTAL
                                                           ==========

Allow 7 days for verification of funds on personal checks.  Payment by
money order or cashiers check will result in immediate assignment of
registration key.

Send coupon by US mail to the below addresses.  Please make all checks
payable to

Kevin Kuphal                     
1011 Cascade Dr.
Aurora, IL  60506

Fidonet 1:115/583.1
Internet KEVIN_KUPHAL@msn.com