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  1.                                Registration for DDUMP Program
  2.                                ------------ --- ----- -------
  3.  
  4.                Please complete the following information and return this
  5.           form with your check or money order (please do not send cash) to
  6.           the address below.
  7.  
  8.           <Please Print Clearly>
  9.  
  10.              Name: __________________________________________________
  11.           Company: __________________________________________________
  12.  
  13.           Address: __________________________________________________
  14.                    __________________________________________________
  15.             <City> _____________________ <St> ___  <Zip> ______-_____
  16.  
  17.             <Date> ___-___-______
  18.  
  19.           Machines: < > 80286  < > 80386  < > Portable
  20.              Disks: < > 360K     < > 720K
  21.  
  22.           Kind of Work You Do:
  23.                   < > Programming      < > CAD/CAM         < > Engineering
  24.                   < > Accounting       < > Word Processing
  25.                   < > Other (Please Specify) _____________________________
  26.  
  27.           I would like to register ____ (copy)(copies) of DDUMP at $15 each.
  28.           This entitles me to receive a serialized copy of DDUMP and to be
  29.           informed of product updates at a special price and of bug fixes.
  30.           I will receive information on contacting you to report bugs.
  31.           If you are a resident of NC, please add 5% sales tax ($0.75) per
  32.           copy.  Enclosed with this please find a (check)(money order) for
  33.           $_______.
  34.  
  35.           Where did you find this product: _______________________________
  36.  
  37.           Comments/Suggestions about this product:
  38.  
  39.           _________________________________________________________________
  40.  
  41.           _________________________________________________________________
  42.  
  43.           _________________________________________________________________
  44.  
  45.           _________________________________________________________________
  46.  
  47.           _________________________________________________________________
  48.  
  49.  
  50.           Please submit to:  Christopher Laforet
  51.                              511-D Poplar St
  52.                              Graham, NC  27253
  53.  
  54.