KillProc v1.00 Order Form
-------------------------

Date: __________________

Name: ___________________________________________________________________

Street: _________________________________________________________________

City: _________________ State/Province:_______________ Zip: _____________

Country:_________________________________________________________________


Phone#: _________________________________________________________________


EMail: __________________________________________________________________


Disk format:  [  ] 3.5"   [  ] 5.25"


Registration --------------------------  $5 x quantity ______ = $________

Comments: _______________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________


Please make out a check or money order to Daniel Otis and
send it along with this completed registration to:

  Daniel Otis
  DSI
  1889 Lindo St.
  Benicia, CA  94510-2315