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  1.  
  2.  
  3.  
  4.                R E G I S T R A T I O N    F O R M
  5.  
  6.  
  7.  
  8. DATE:                    _________________________________________
  9.  
  10. YOUR NAME:               _________________________________________
  11.  
  12. COMPANY NAME:            _________________________________________
  13.  
  14. STREET ADDRESS:          _________________________________________
  15.  
  16. CITY, STATE, ZIP CODE:   _________________________________________
  17.  
  18. PHONE NUMBER:            _________________________________________
  19.  
  20. COMPUTER BRAND AND MODEL:_________________________________________
  21.  
  22. DISKETTE SIZE (Check One)  3.5 inch [ ]     -or-    5.25 Inch [ ]
  23.  
  24. Do you presently use CheckBook versions 3.0 or 4.0? _____________
  25.  
  26. Please Indicate the source of your shareware disk: ______________
  27.  
  28. _________________________________________________________________
  29.                                                             U.S.
  30.                     DESCRIPTION                           DOLLARS
  31. --------------------------------------------------        -------
  32. Latest Version of CheckBook Plus                           $24.95
  33. Printed User's Guide and Reference Manual                     N/C
  34. Software Updates For One Year                                 N/C
  35. Letter or Phone Support                                       N/C 
  36. Database File Compression Utility (ISAMPACK.EXE)              N/C
  37.  
  38. Shipping & Handling Charge                                   5.00
  39.                                                           -------
  40.     Total                                                  $29.95
  41.                                                           =======
  42.  
  43. Make check payable to: Beshears Software Associates
  44.  
  45. Mail Registration Form and Payment to:
  46.  
  47.                   Beshears Software Associates
  48.                         5710 Rita Street
  49.                       Southside, AL  35903 
  50.                       
  51. Your comments and suggestions are important to us.  Please use
  52. the reverse side of this form.
  53.  
  54. cb+52