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  1.                Registration form: The Structured Programming Language
  2.  
  3.                JR
  4.  
  5. Name:          ________________________________________________________
  6.  
  7. Street:        ________________________________________________________
  8.  
  9. City,State:    ________________________________________________________
  10.  
  11. Phone:         ________________________________________________________
  12.  
  13.  
  14.        I have used the Structured Programming Language for the one month trial
  15.        period and I am satisfied with it. I pledge to purchase the software
  16.        for an amount of    O $50    O $75    O $100 and will make payment by
  17.        check made to Dennis Baer when I receive a bill for the amount.
  18.  
  19.                                        Signed:  ___________________________
  20.  
  21. Print out this form and send it with a self addressed stamped envelope to:
  22. Dennis Baer
  23. 25 Miller Road
  24. Farmingdale,NY 11735             516 694 5872
  25.