Please print this form ('COPY REG_ENG.TXT PRN') and send it together with
the registration fee to: XSS; Gr. Diesdorfer Str. 26; 39108 Magdeburg; Germany
If you pay with credit card just Fax the printed form to: +49-391-7442602
------------------------------------cut here----------------------------------
                     Registration Form for MOD4WIN 2.30

First Name: _________________ Last Name: _________________ Phone:____________

Mailing Address: _________________________________________ Fax. :____________

                 _________________________________________

>Payment:
 New user registration for MOD4WIN 2.30          45,- DM     ___________,- DM
 plus for Check or direct Deposit                15,- DM     ___________,- DM
 Update from MOD4WIN before 2.20                 15,- DM     ___________,- DM
 Update from MOD4WIN 2.2x                         0,- DM
 I don't have MOD4WIN Send me a 3.5" Disk         5,- DM     ___________,- DM

=Total price:                                                ___________,- DM

Method of payment:
( )Credit Card (EURO Card; VISA; MasterCard; American Express; Diners Club)
   card number: ____-____-____-____ expiration date: __/__

   Your signature:

( )Direct deposit to Deutsche Bank Ilmenau Bank Code 82070000 Account 4465134
( )Check
( )Cash
( )Payment order

The following information about your hardware is optional, however if you
choose to provide it, you will help us serve our customers and their
needs better in the future:

eMail:___________________________

How did you learn about MOD4WIN?_____________________________________________
_____________________________________________________________________________

Comments, Suggestions for MOD4WIN:___________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

Do you want to get informed about further major developments?    ( )YES/( )NO

Your Hardware:

Processor:( )386 ( )486 ( )Pentium ( )Other:________ Processor Speed:_____MHz

Main Memory: ____________________ MB / Hard Drive(s): ____________________ MB

Graphics Board: ____________________ BUS: ( )MCA ( )ISA ( )EISA ( )VLB ( )PCI

Sound Card(s):______________________ CD-ROM(s):______________________________