Registration Form
for Black Hole Screen Saver



   Name :______________________________________________________
   
   Address :___________________________________________________
   
   City,State,Zip  :___________________________________________
   
   E-Mail  :___________________________________________________
   
   
   
   Would you prefer your Registration Number be e-mailed? Y / N
   
   
   Where did you find this program : __________________________
   
   
   Comments / What you want in an upgrade :____________________
   
   ____________________________________________________________
   
   ____________________________________________________________

   ____________________________________________________________
   
   
   Send $10.00 ( Texas residents add $.83 sales tax) to :
        
        Oirck Software
        17610 Midway Rd. # 134-116
        Dallas, TX  75287-6799
   
  
   ( Registration includes only a Registration # which prevents
     the "please register" message from being displayed. It does
     NOT include a disk or printed documentation. )