LView Pro 1.B -- Individual User Registration Form

1. User information:

Name: ___________________________________________________________
Address: ________________________________________________________
City: ___________________ State: _____________ ZIP: _____________
Country (if other than U.S.A.):__________________________________
Phone number: (___)______________ Date (MM/DD/YY): ____/____/____
E-mail address (optional): ______________________________________

2. Choice of registered version (check one):

__ 386         Windows 3.1, 16-bit application
__ 386         Windows 3.1+Win32s/Windows NT, 32-bit application
__ 486/Pentium Windows 3.1, 16-bit application
__ 486/Pentium Windows 3.1+Win32s/Windows NT, 32-bit application

3. Shipping and Handling (check one):

__ E-mail uuencoded file to: ____________________________________
__ 3.5'' DS/HD disk

4. Payment and fees:

Fees are in U.S. dollars, please do not send cash. Checks and
money orders must be made payable to MMedia Research.
Select form of payment (check one):

__ Enclosed check or money order in U.S. dollars
__ Credit card payment: ___ VISA   ___ MasterCard    
   Card Number: ______________________________
   Expiration Date (MM/YY): ____/____
   Cardmember signature (required): ______________________________

Check all that apply and fill in the blanks:

__ One registered copy of LView Pro 1.B or newer...........$30.00
__ U.S. Shipping and handling (if other than E-mail)........$5.00
__ Non U.S. Shipping and handling (if other than E-mail)...$12.00
__ Florida residents add appropriate sales tax.............$_____

Total:.....................................................$_____

5. Mail this form together with payment to:

	MMedia Research
   Attn: Leonardo Haddad Loureiro
   1501 East Hallandale Beach Boulevard, #254
   Hallandale, FL 33009
   USA

   Or: If credit card payment was selected, this form may be faxed to 
   305-458-9698 (Florida, U.S.A.) or E-mailed to mmedia@world.std.com.