Direct Registration Form
Dialog View version 2.1.7

Name:

________________________________


Address:

________________________________

________________________________

________________________________


E-mail: (print clearly)

________________________________


______  US $10 - single-user license

______  US $300 - institution site license

______  US $1500 - institution world-wide license

______  US $5 - disk with current version and other shareware & freeware

______  TOTAL

Confirmation will be given by Email only unless explicitly requested.

James W. Walker
766 S. Nardo Ave. #C9
Solana Beach, CA  92075  U. S. A.

You may pay by cash (any currency), check (in U.S. funds drawn on a U.S. bank), or postal money order (in U.S. funds).  If you pay by foreign cash (no coins, please), use the current exchange rate and add about 5% for handling.