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                        FLU_SHOT+ (V1.81) Registration

Please fill out this form, then mail it along with a check for $19 ($15
Registration, $4 Shipping/Handling/Processing) or with authorization
to charge this amount to your credit card to:

                         Ross M. Greenberg
                         Software Concepts Design
                         594 Third Avenue
                         New York, New York 10016
                         FAX: (212)-889-9730

Thanks for your support!

        Name:_________________________________________________________

        Title:________________________________________________________

        Company:______________________________________________________

        Address:______________________________________________________

                ______________________________________________________

        City:   _____________________     State: _________  Zip:______

        Telephone:________________________        [__] 5.25" [__] 3.5"

        Number of copies:  __________ x $15  =     $________.____
            Shipping and Handling:               + $       4.00
                                                   ==============
            Total of Order:                        $________.____

[__] Check Enclosed for the above amount.

[__] Bill my Credit Card (MasterCard or Visa Only) for the above amount.

       ___________________________________________       _______________
                   Credit Card Number                    Expiration Date


Comments and Suggestions:____________________________________________________

         ____________________________________________________________________

         ____________________________________________________________________

         ____________________________________________________________________


Where did you get FLUSHOT+ (V1.81) from? (check one, fill in the blank):

        [__]  User Group  (which one:________________________________________)

        [__]  BBS  (Name:_______________________)(Tel #:_____________________)

        [__]  Other (Such as:________________________________________________)


[__]    Please send me more information RamNet, the background
        communications program.