===================== TinyPort Registration Form ==================

>>>  IMPORTANT NOTE: please use this form ONLY if there is no other
>>>  way for you to pay than by mailing a US dollar check.

>>>  Otherwise, use the form in REGISTER.TXT.


Name: _____________________  Company: _____________________________

Address: __________________________________________________________

City, State, Zip: _________________________  Country: ______________

E-Mail: _________________________________________  Date: ___________

TinyPort shall be registered to (please check ONE)

     _  my NAME, exactly as spelled above

     _  my COMPANY, exactly as spelled above

     _  instead to: ________________________________


TinyPort License (see LICENSE.TXT for details)
                      ____  copies at $75 each =            $ ______

Customers in the EC add 15% VAT,                          + $ ______
  OR give us your VAT Nr.: _____________________

Check fees
  (sorry, but those German banks ...)                            +$3

                         Total payment                      $ ______



_ Please send me an invoice together with my registration number.

____________________________________________________________________

Please mail this form, together with your check, to:

Manfred Keul GmbH, Landsbergstr. 16, D-50678 Koeln, Germany