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  1.                     Xerix Registration Form
  2.  
  3.                        Free Registration
  4.  
  5.    Name: __________________________________________________
  6.  
  7. Address: __________________________________________________
  8.  
  9.          __________________________________________________
  10.  
  11. City/Suburb/Province: _____________________________________
  12.  
  13. State: ____________________________________________________
  14.  
  15. Zip/Post code: _________________   Country: _______________
  16.  
  17.  
  18. Please fill out the following, marking all that apply.
  19.  
  20. Processor:  ___80286 (AT)          Display:  ___MCGA (PS/2)
  21.             ___80386SX                       ___VGA
  22.             ___80386                         ___Super VGA
  23.             ___i486
  24.  
  25. Sound card/module:                 Floppy Disk drive(s):
  26.             ___none                          ___5.25 inch
  27.             ___Adlib                         ___3.5 inch
  28.             ___Sound Blaster
  29.  
  30.             ___Adlib Gold          DOS:      ___MS-DOS ver:__
  31.             ___Sound Blaster Pro             ___DR-DOS ver:__
  32.             ___Pro Audio Spectrum            ___MS Windows
  33.  
  34.             ___Roland MT-32/LAPC-1 or compatible
  35.             ___other: ___________
  36.  
  37. Other Devices:
  38.             ___CD-ROM
  39.             ___Modem
  40.             ___2-button Mouse
  41.             ___3-button Mouse
  42.             ___Joystick
  43.  
  44. Comments/Suggestions: _____________________________________
  45.  
  46.           _________________________________________________
  47.  
  48.           _________________________________________________
  49.  
  50.      Please post to: 
  51.           Brendan Reville, 
  52.           PO Box 304,  Milsons Point NSW 2061,  Australia.
  53.  
  54.      Thank you for returning this registration form.