-=DEAD PAINT Reg. Form=-            *Version 2.1*
-----

Checks or Money Orders please.

Please make checks payable to: Danny w. Leong


Send it to:      Dead Paint
                 P.O. Box 2341
                 Daly City, CA  94017


To receive a registered copy, please send in $20.00 in U.S. Funds, plus
$3.00 for postage/handling.

Registered user of v.2.0, send in $3.00 ($5.00 outside U.S.) for
postage/handling on free upgrade.

(Outside United State orders: Please send in $5.00 for postage/handling.
Also, please send in US currency)

New registration  - [ ] $20.00 + $3.00
(Outside U.S.)      [ ]        + $5.00
Upgrade from 2.0  - [ ]  FREE  + $3.00
(Outside U.S.)      [ ]        + $5.00


Disk Size:        - [ ]  5 1/4
                    [ ]  3 1/2


Your name: ______________________________________________________________

Address:_________________________________________________________________

City,St,Zip,Country:_____________________________________________________

Phone number (voice):____________________________________________________

BBS name: ________________________ BBS Phone number: ____________________

BBS software:______________________________ Version: ____________________



Comments:________________________________________________________________

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Signature____________________________________   Date:____________________