**************************************************************************** Desktop Strip 1.2.1 Shareware Registration Form **************************************************************************** Name________________________________________________________________________ Company_____________________________________________________________________ Address_____________________________________________________________________ City____________________________ State_______________________ Zip___________ Country___________________ E-Mail_______________________________________ **************************************************************************** Shareware Fees -------------- 1 - 5 Copies - US$ 20.00 per copy 6 - 20 Copies - US$ 17.00 per copy 21 - 50 Copies - US$ 14.00 per copy 50+ Copies - Contact Men & Mice Number of Copies _______ @ ______ Total US$ _________ ____ Send me an invoice **************************************************************************** Method of Payment: ____ Cash (We prefer US$ but we also accept a equivalent amount in JPY,DEM, FRF,GBP,BEC,NLG,CHF,CAD,ITL,ATS,PTE,ESP,IEP,DKK,NOK,SEK and FIM) ____ Check (Please use one of the above currencies and make checks payable to Men & Mice) ____ Visa ____Mastercard ____Amex #_________________________ Exp Date ______ Signature_________________________________________ Date_____________________ Mail to: Men & Mice P.O. Box 7238 127 Reykjavik ICELAND E-mail: AOL: MenAndMice CompuServe: 100045,2425 Internet: registrations@menandmice.is Fax: +354-525-4991 *** THANK YOU FOR SUPPORTING SHAREWARE ***