Time Palette Registration Form - 2.1
Please print, fill out, and mail this form along with your payment.

Please add me to your list of registered users. I have enclosed USD $25 (or foreign cash equivalent). All checks must be in US Dollars.

Send payment to:

          Tryg Inda
          P.O. Box 11524
          Reno, Nevada 89510
          United States of America

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Name:

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Full Address (including country):

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From what source did you receive Time Palette?

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Additional comments / suggestions:

(Please indicate if you are using the Kanji version of Time Palette)