Registration form for UZPronto 1.21 from UZful Software
    ----------------------------------------------------------------------
    Send to:
            UZful Software, Inc.
            PO Box 2089
            Merrimack, NH 03054-2089, USA

    Individual Registered Version          Qty ____ @ $15.00  $___________


    OPTIONAL: 1 floppy disk with latest version     + $ 5.00  $___________
    (  ) 5.25" or (  ) 3.5"

    Note: All payments must be in U.S. funds,         Total   $___________
    drawn on a U.S. bank.


    ______________________________________________________________________
    Name      Last                          First

    ______________________________________________________________________
    Title                                   Company Name

    ______________________________________________________________________
    Street Address                          City

    ______________________________________________________________________
    State/Province/Region                   ZIP/Postal code

    ______________________________________________________________________
    Country              E-mail address (Internet, MSN, CompuServe, ...)

    Where did you get your copy of the program? __________________________


    What brand(s) and model(s) of computer do you use? ___________________

    +----------------------------------------------------------------+
    | Please include the output of the "uzlicinf" program for the    |
    | computer(s) on which you want to run this product.             |
    +----------------------------------------------------------------+

    UZLICINF OUTPUT (8 capital letters): _____________

    Please return feedback (comments, problems, wishes) below, or e-mail
    us the customer satisfaction survey (SATISFAX.TXT). Thanks!


    ______________________________________________________________________


    ______________________________________________________________________


    ______________________________________________________________________