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  1.  ========================= ORDER/REGISTRATION FORM ============================
  2.  
  3.  Send this completed form to:
  4.  
  5.         LED REGISTRATION
  6.         P.O. BOX 1126
  7.         MARTINSVILLE, VA 24114
  8.  
  9.  Funds (U.S. only) payable to:  NEOCOM Microspecialists, Inc.
  10.  
  11.  ------------------------------------------------------------------------------
  12.   SINGLE COPY REGISTRATION (per copy)
  13.   Disk with program and documentation  $15.00 (includes P&H)
  14.  ------------------------------------------------------------------------------
  15.   SITE LICENSE (MULTI-COPY) REGISTRATION
  16.  
  17.           PCs                      Price
  18.       --------------------------------------
  19.           2 - 5                   $call
  20.           6 - 19                  $call
  21.          20 - 49                  $call
  22.          50 - 99                  $call
  23.         100 or more, $call one time fee. (Call 703/666-9533 for details)
  24.  
  25.   (Overseas orders please add $5.00 per order)
  26.  
  27.  No. Copies:          _________ (x $15 per copy)
  28.                    =  _________
  29.  
  30.  Shipping & Hand.: + $     0.00
  31.  Overseas:         + $______.__ ($5.00 if applicable)
  32.  
  33.  Total enclosed:     $______.__
  34.  
  35.  Company Name (if applicable): ______________________________________________
  36.  
  37.  Your Name: _________________________________________________________________
  38.  
  39.  Address: ___________________________________________________________________
  40.  
  41.  City: _________________________ State: ___  Zip: ______
  42.  
  43.  Telephone: (    )___-____          Version you have: _______
  44.  
  45.  Preferred diskette type (check one):         3½ [ ]     5¼ [ ]
  46.  
  47.  Computer/configuration: ____________________________________________________
  48.  
  49.  How and where did you find out about LED? __________________________________
  50.  
  51.  ____________________________________________________________________________
  52.  
  53.  Do you have any comments and/or suggestions regarding
  54.  
  55.  LED?  ______________________________________________________________________
  56.  
  57.  ____________________________________________________________________________
  58.