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  1.                       -=DEAD PAINT Reg. Form=-            *Version 2.1*
  2. -----
  3.  
  4. Checks or Money Orders please.
  5.  
  6. Please make checks payable to: Danny w. Leong
  7.  
  8.  
  9. Send it to:      Dead Paint
  10.                  P.O. Box 2341
  11.                  Daly City, CA  94017
  12.  
  13.  
  14. To receive a registered copy, please send in $20.00 in U.S. Funds, plus
  15. $3.00 for postage/handling.
  16.  
  17. Registered user of v.2.0, send in $3.00 ($5.00 outside U.S.) for
  18. postage/handling on free upgrade.
  19.  
  20. (Outside United State orders: Please send in $5.00 for postage/handling.
  21. Also, please send in US currency)
  22.  
  23. New registration  - [ ] $20.00 + $3.00
  24. (Outside U.S.)      [ ]        + $5.00
  25. Upgrade from 2.0  - [ ]  FREE  + $3.00
  26. (Outside U.S.)      [ ]        + $5.00
  27.  
  28.  
  29. Disk Size:        - [ ]  5 1/4
  30.                     [ ]  3 1/2
  31.  
  32.  
  33. Your name: ______________________________________________________________
  34.  
  35. Address:_________________________________________________________________
  36.  
  37. City,St,Zip,Country:_____________________________________________________
  38.  
  39. Phone number (voice):____________________________________________________
  40.  
  41. BBS name: ________________________ BBS Phone number: ____________________
  42.  
  43. BBS software:______________________________ Version: ____________________
  44.  
  45.  
  46.  
  47. Comments:________________________________________________________________
  48.  
  49. _________________________________________________________________________
  50.  
  51. _________________________________________________________________________
  52.  
  53. _________________________________________________________________________
  54.  
  55. _________________________________________________________________________
  56.  
  57.  
  58.  
  59. Signature____________________________________   Date:____________________
  60.