Mac-ImageMap 1.4.1 Registration form

Please, take two minutes and fill in the fields of this form. You don't need to supply information for all fields, if you don't like, but if you send the form, please at least supply your name and e-mail address.
Use NetScape to fill in this form. Your data will be sent to me bye-mail to me. Such, sending this form should always work, independent of the current state of my Web-server and the network.

Thanks.

Your name:
Your e-mail address:
Name of your organization:
Business address:
Street, Number:
Town, Postal Code, State:
Country:
Phone:
Fax:
URL:
Comments: