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		  RODGE ROCK in RETRO ACTIVE REGISTRATION FORM
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		   YES, I'd like to receive registered copy of
			  RODGE ROCK in RETRO ACTIVE !

			Print this form, fill in the details and
				return to us !


	 NAME:_____________________________________________________

	  ADDRESS:_____________________________________________________

		  _____________________________________________________

	 CITY:________________________ STATE/PROV:_________________

	 ZIP CODE:____________________ PHONE/FAX:______________________

		  COUNTRY (if not AUSTRALIA):______________________

	   Australian orders: $39.95 per copy
		 U.S. orders: $29.95 (US dollars) per copy
		 European orders: œ19.95 per copy

AUSTRALIAN ORDERS:  _____ copies @ $39.95 plus $5.00 P/H ea : _______

	  U.S. ORDERS:  _____ copies @ $29.95 plus $4.00 P/H ea : _______

  EUROPEAN ORDERS:  _____ copies @ œ19.99 plus œ3.00 P/H ea : _______

											>> TOTAL PAYMENT: _______

DISK TYPE:    ( ) 3.5 inch  ( ) 5.25 inch

PAYMENT TYPE: ( ) Check  ( ) Money Order

 ( ) Bankcard  ( ) Visa   ( ) MasterCard   

CARD NUMBER:_____________________________________________________

EXPIRATION DATE:_____/_____   SIGNATURE:_________________________

NAME ON CREDIT CARD (if different from above):___________________

	   Make checks payable to Rodge Rock Software

		 ORDERS MAIL TO:
		 Rodge Rock Software
		 PO Box 682
		 Scarborough 6019
		 Western Australia