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  1.  
  2.                                 PCForm
  3.                              Version 3.0
  4.                       Software Registration Form
  5.      ____________________________________________________________
  6.  
  7.  
  8.      CareWare
  9.      10217 Ridge View Dr.
  10.      Grass Valley, CA  95945                  Date: _____________
  11.  
  12.  
  13.      Count          Description               Amount       Total
  14.      -----          -----------               ------       -----
  15.  
  16.      _____ PCForm registration only         $25.00 ea   $ _______
  17.  
  18.      _____ PCForm registration and latest   $30.00 ea   $ _______
  19.            version on disk (includes Find
  20.            File Utility)
  21.  
  22.            Disk size:  ( ) 5 1/4"  (360K)
  23.                        ( ) 3 1/2"  (720K)
  24.  
  25.            Please add $4.00 for disk shipping
  26.            outside of U.S.  (first class air)           $ _______
  27.  
  28.                                    Total submitted      $ _______
  29.  
  30.  
  31.      Name: ______________________________________________
  32.  
  33.      Address: ___________________________________________
  34.  
  35.               ___________________________________________
  36.  
  37.               ___________________________________________
  38.  
  39.      Phone: _____________________________________________
  40.  
  41.      Please  help us track the distribution of PCForm and
  42.      let us know where you found this copy.
  43.  
  44.      ____________________________________________________
  45.  
  46.      Comments: __________________________________________
  47.  
  48.      ____________________________________________________
  49.  
  50.      ____________________________________________________
  51.  
  52.  
  53.      Please make payable to the author  -  R. J. Crouch
  54.  
  55.      ORDERS  OUTSIDE  OF  THE  U.S.  -  Please send international
  56.      postal or money orders in U.S. dollars.
  57.  
  58.      Thank you for registering PCForm.
  59.  
  60.