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                  A D D R E S S A S S I S T  release 2

                         REGISTRATION/ORDER FORM


mail:  Alex Schneider                   email:  schneidr@igt.baum.ethz.ch
       Kruggasse 179	   	    	    schneida@hoggar-ether.ethz.ch
       CH-5462 Siglistorf / Switzerland		

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AddressAssist registration:                       SFr      DM     $US

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

    [] Extra postage inside Europe ............. 5.00*   5.00*   5.00*

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

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

* only necessary if you like a printed manual and the newest version 
  of the program sent by mail. No extra is necessary if you like the
  key-file to be sent by e-mail or on disk by mail. 

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

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    Name_______________________________________  Phone___________________

    Company______________________________________________________________

    Address______________________________________________________________

    City_______________________________________  State___________________

    Country____________________________________  PostCode________________

    E-Mail_____________________________________  FAX_____________________

    System_______________________________________________________________

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