MicroMixer Registration Form
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Please fill up all the blanks in the form.  The author reserves the right to
reject any forms that are not properly filled.  Registration charges can be
found at the bottom of this form.

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1.  Name:___________________________________________________________________

2.  Please tick one of the following options:

    [  ]  I would like to receive MicroMixer via e-mail(Internet) or
    [  ]  I would like to receive MicroMixer via postal mail.

3.  Please fill-in the following with regard to your choice made in 2:

    E-Mail Address:_________________________________________________________

    or

    Postal Address:_________________________________________________________

                   _________________________________________________________

                   _________________________________________________________

4.  Enclosed is my Money Order or Cash of:

    [  ]  S$____        (for Singapore users)
    [  ]  US$____       (for overseas users)
      
5.  My comments or suggestions for MicroMixer (if any):

    ________________________________________________________________________

    ________________________________________________________________________

    ________________________________________________________________________

    ________________________________________________________________________

    ________________________________________________________________________

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REGISTRATION CHARGES
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Registration fee is S$10 for Singapore users or US$10 for overseas users.
A postal fee of S$5 for Singapore users or US$5 for overseas users is to be
included for users who want to receive MicroMixer via postal mail.

* Note:  Distributions via postal mail are done with 3.5" disks.

Please make all Money Orders payable to Yip Kah Heng.

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REGISTRATION ADDRESS
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Please send all registration forms to the address below:

        Yip Kah Heng
        Blk 634, #02-52
        Yishun Ring Road
        Singapore 760634
        Republic of Singapore