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  1.    Thank you for using this product. If you continue to use 
  2. it for 30 days, you MUST register. When you register, you will 
  3. receive the latest registered version of Fortune Teller, and periodic 
  4. updates on WaWa Pen Ware products. The registration fee is $4.00.
  5. Please fill out the form below and send it with the registration 
  6. fee to:
  7.             
  8.             WaWa Pen Ware
  9.             R.D.2, Box # 28, 
  10.             Petersburgh, NY 12138
  11.  
  12.                  Thank you for your support! 
  13.  
  14.  
  15.  
  16.  
  17.  
  18. -----------------------------------------------------------------------
  19. I am registering Fortune Teller. I have enclosed $4.00, and I 
  20. have completely filled out this form.
  21. -----------------------------------------------------------------------
  22.                                       
  23. First Name:_________________ Last Name:_________________       
  24.  
  25. Address:________________________________________________
  26.  
  27. City/State:_____________________________________________
  28.  
  29. Zip Code: _______________
  30.  
  31.  
  32. Phone Number (OPTIONAL!) (______)_______________________
  33.  
  34.  
  35. I would like (circle 1)       5 1/4" disks    
  36.  
  37.                   3 1/2" disks    
  38.             
  39.                   No Preference
  40.  
  41.  
  42.  
  43. Comments:_______________________________________________
  44.  
  45. ________________________________________________________
  46.  
  47. ________________________________________________________
  48.  
  49. ________________________________________________________
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  51. ________________________________________________________
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  53. ________________________________________________________
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  55. ________________________________________________________
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