S H O R T W A V E  L O G

                    R E G I S T R A T I O N  F O R M

                             (Version 1.20)

               Send this form to swlog@edc3.gsph.pitt.edu



Name             _________________________________________

Address          _________________________________________

City             _________________________________________

State/Province   _________________________________________

Zip/Postal Code  _________________________________________

Country          _________________________________________

E-mail address   _________________________________________


Where did you find Shortwave Log? 

______________________________________________________________________



Finally please list any comments, bugs, or suggestions for future versions: