=================================
                 Canasta 4.0 for Windows 95 and NT
                         Registration Form
                 =================================

NOTE: Please refer to README.TXT file for payment methods
    
	      				 Date _________________


First Name ________________ Last Name _________________________

Address _______________________________________________________

City __________________________  State/Country ________________

Zip/Postal Code  _______________ Fax* _________________________

E-mail address* _______________________________________________

[ ] Check here if you want a free listing on the 
    Canasta Internet Player List.

How did you obtain Canasta ?* _________________________________

Registration at $19.95 		                           ____

Premium of $10 if payment with a check or money order
drawn on a non-US bank or not drawn in US dollars 
(except Eurocheques - 
 these must be in Dutch guilders (HFL))                    ____

TOTAL AMOUNT 						   ____

* : not required.

Note 1: Checks must be made payable to 'Mark-Jan Harte'.
Note 2: For Eurocheques, please remember the code on the back.

Mail to:

Mark-Jan Harte
Cort v.d. Lindenlaan 84
1412 CB Naarden
The Netherlands
		

Please state any suggestions or comments below.