Registration/Order Form
------------------------------------------------------------------------
If, after tring MH CALL BACK 2.0, you decide to purchase a registered
license, use this form to process your order. After receiving your
order, we'll send you a registered copy of the software. Registration
 also entitles you to free BBS support & FREE PRIVATE PAGING DOOR.


MAIL      MIKE HEIN, 23023 CALIFA ST  WOODLAND HILLS, CA 91367, USA
FAX       COMMING SOON     (include your FAX number with order)
BBS       818-999-0429  8N1, 1200-14.4K BPS,  HST

CUSTOMER  Name _________________________________________________________
          PASSWORD _____________________________________________________
          Company or BBS _______________________________________________
          Address ______________________________________________________
          City _______________________ State ___________  Zip __________
          Country ____________________ Phone ____________ Fax __________

PRODUCTS  MH CALLBACK  
                   
          Standard Ver 2.0..Qty____ x $ANY DONATIONS           $__.___
          Advanced Ver 1.0..Qty____ x $10.00 ea.  you call BBS $__.___
                                      
          Private page door            Free with portch        X___
          
          FREE DEMO DISK OF ALL MIKE HEIN & BRIAN VEDITZ PRG.  X___
                                           + SHIPING COST
          TOTAL PRODUCT ORDER (totals from above)............ $_________



SHIPPING  TOTAL SHIPPING COST (from list below).............. $_________
          Continental United States = $2.90  (U.S. AIRMAIL)
          Canada and Mexico         = $4.00  (U.S. AIRMAIL)
          All other countries       = $10.00 (U.S. AIRMAIL)
          

TOTAL     TOTAL PAYMENT ENCLOSED (in U.S. Dollars)........... $_________
          (Add totals in right column)

PAYMENT   ( ) CASH  
          ( ) CHECK         PAD TO (MIKE HEIN)
          ( ) MONY ORDER 
                                                                        

              Signature ___________________________________

FORMAT    ( ) 5 1/4" 360k
          ( ) 5 1/4" 1.2K
          ( ) 3 1/2" 720k
          ( ) 3 1/2" 1.4K






        
        MAIL THIS FORM AND ANY FEE TO
      
         MIKE HEIN
         23023 CALIFA ST
         WOODLAND HILLS, CA
                           91367
 _____________________________________________________________________
M.H. USE ONLY

Ordered____________ S/N ___________ Inv ___________ Shipped ____________