WinDates 5.1 Registration Form


Company__________________________________________________

Name_____________________________________________________(required)

Address___________________________________________________

Address___________________________________________________

City ______________________________________________________

State_________________ ZIP_______________________

Country____________________________________________________

Phone_____________________________________________________

email______________________________________________________ (print clearly!)

Cost:

WinDates: $19.95 x ____ copies = $_______
Shipping Method (check one)

Code Via Email Free

______

U.S. / Canada Postal $3.00

______

International Postal $5.00

______

Shipping Cost

$_______
Tax 8.25% (only pay tax if you live in Texas) $_______

$19.95 tax = $1.65

$22.95 tax = $1.89

Total $_______


Send this form and a Check or Money Order payable through a U.S. Bank to :

Rockin' Software
5116 Bissonnet #134
Bellaire, TX 77401-4007

Optional

Where did you obtain WinDates? (Internet site address, disk vendor name)

_____________________________________________________________