Gold'N Years Registration Form


 Name:     _____________________________________    Please send your $10.00 (US)
                                                    registration fee along with
 Company:  _____________________________________    this completed form to:

 Address:  _____________________________________      Maristream, Inc.
                                                      2015 Franklin Street
           _____________________________________      N. Little Rock, AR  72114
                                                      (USA)
 City:     _____________________________________

 State/Province:   _____________________________

 Zip/Postal Code:  _____________________________

 Country (if not USA):  ________________________

 E-Mail Address:  ______________________________  (for update notifications)

 Found At:  __________________________________________    Gold'N Years
 (Internet Site Address, CD-ROM Collection Name, etc.)    Version Number:  ____

 Comments/Suggestions: