This form is provided for your convenience; it isn't required: Name: __________________________________________________________ Name for registration: _________________________________________ Address: _______________________________________________________ _______________________________________________________ _______________________________________________________ Shareware version you have: ___________________________________ Where you got it: ______________________________________________ Preferred media: ___ 5-1/4" 360K ___ 5-1/4" 1.2mb ___ 3-1/2" 720K ___ 3-1/2" 1.44mb _____ personal-use registration(s) X $25.00 ea. US _____ commercial-use registration(s) X $50.00 ea. US _____ total registrations $__________ US enclosed Commments/Suggestions (include separate sheet if desired): _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ Mail to: Mark Kimes 542 Merrick Shreveport, LA USA 71104 Thank you for registering.