=========================================================================
                         A D D R E S S A S S I S T 

            REGISTRATION/ORDER FORM (version 1.0 release 38.15)


mail:  Alex Schneider                   email:  schneidr@igt.baum.ethz.ch
       Bachtobelstrasse 13		    schneida@hoggar-ether.ethz.ch
       CH-8106 Adlikon / Switzerland		

Swiss francs are preferred, though the cash  equivalent in 'DeutscheMark'
and 'US-Dollars' will be accepted.  Foreign  check orders should  include
extra to cover collection fees. No credit cards yet, sorry.

=========================================================================
AddressAssist registration:                       SFr      DM     $US

    [] Shareware Registration...................30.00   30.00   25.00

    [] Extra postage outside Europe ............10.00   10.00   10.00

    Total                      Currency ...:                         
                                                =====   =====   =====
=========================================================================


    Name_______________________________________  Phone___________________

    Company______________________________________________________________

    Address______________________________________________________________

    City_______________________________________  State___________________

    Country____________________________________  PostCode________________

    E-Mail_____________________________________  FAX_____________________

    System_______________________________________________________________

=========================================================================