10-20-30 Program Registration Form
          __________________________________

If you would rather use your credit card for
payment and register online, check my website
at www.enc.yk.net/10-20-30/ for details.



Your Name: _______________________________________

Street Address: __________________________________

City: ____________________________________________

Province/State: __________________________________

Postal Code/ZIP: _________________________________

Country: _________________________________________


Optional: email address
(I will email you the serial number if you provide it):

__________________________________________________

How did you learn about this program?

__________________________________________________

__________________________________________________

__________________________________________________

__________________________________________________





Mail this completed form to:

Rod Carty,
29 Bates Crescent,
Whitehorse, Yukon, Canada
  Y1A 4T8


Include a money order for $15.00 in Canadian funds.
(Sorry, no cheques accepted.)


Thanks for supporting my efforts, and for supporting
the shareware concept.