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  1. ZipIt Registration Form
  2.  
  3. Name:         _______________________________________________
  4. Organization: _______________________________________________
  5. Address:      _______________________________________________
  6.               _______________________________________________
  7. Country:      _____________
  8.  
  9. Phone: __________________
  10. Fax:   __________________
  11.  
  12. ZipIt version: 1.3.4
  13.  
  14. Where did you obtain ZipIt? ______________________________
  15.  
  16. Please indicate up to five electronic addresses. Place an asterisk next to the one you prefer:
  17.  
  18. ______________________________
  19. ______________________________
  20. ______________________________
  21. ______________________________
  22. ______________________________
  23.  
  24. If registering with NetCash, please enter your $15 NetCash certificate(s) here: ____________________________
  25.  
  26. If using NetCash, please email this form to tbrown@dorsai.org. Otherwise, please mail to:
  27.  
  28. September through April:
  29. Tom Brown
  30. P.O. Box 203425
  31. New Haven, CT  06520-3425
  32.  
  33. May through August:
  34. Tom Brown
  35. 110-45 Queens Blvd. Apt. 716
  36. Forest Hills, NY  11375
  37.  
  38. Please see the documentation regarding corporate registrations and site licenses.
  39.  
  40. Thanks for registering!