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            Monitor Expander Shareware Registration Form
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Name________________________________________________________________________

Company_____________________________________________________________________

Address_____________________________________________________________________

City____________________________ State_______________________ Zip___________

Country___________________ Phone (____)______-______ Fax (____)______-______

E-Mail_______________________________________
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Shareware Fees
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Single Machine            -   US$ 25.00
2 - 20 Copies             -   US$ 15.00 per copy
Unlimited Site License    -   US$ 350.00

Number of Copies  ____  @ ____ Total US$ _________

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Method of Payment:

____ Cash

____ Check (US funds only.  Please make checks payable to Men & Mice)

____ Visa ____Mastercard ____Amex #_________________________ Exp Date ______
Note: If you pay by Credit Card you will be charged in Icelandic krona and 
      there could be a slight inaccuracy in the dollar amount due to currency 
      fluctuations.

Signature_________________________________________ Date_____________________

Mail to:
Men & Mice
P.O. Box 7238
107 Reykjavik
ICELAND

Electronic mail to:
me-registrations@rhi.hi.is

Phone: +354-169-4596
Fax: +354-169-4991

                     *** THANK YOU FOR SUPPORTING SHAREWARE ***
                        Please allow 4-6 weeks for delivery