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  1. SDN
  2.                        REGISTRATION FOR DelEx 1.26
  3.  
  4. Please send payment to:
  5.                         Samuel Kaplin
  6.                         3520 West 32nd Street #214
  7.                         Minneapolis, Minnesota 55416-4529
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  12. NAME___________________________________PHONE_________________________________
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  14. ADDRESS______________________________________________________________________
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  16. CITY/STATE/ZIP/COUNTRY_______________________________________________________
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  18. [  ] Copies of DelEx              @  $6.00 per copy.
  19. [  ] Site licences for DelEx      @  $36.00 per facility.
  20. [  ] Check here for 3½ inch disk. @  $ 1.00 per copy
  21.  
  22. Canadian orders please add $2.00 shipping and handling.
  23. Foreign orders please add $10.00 shipping and handling.
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  25. All payments MUST be in United States dollars.
  26. All checks must be drawn on a United States bank.
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  29. Payment by:   [ ] Check [ ] Money Order       TOTAL ENCLOSED_____________
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  32.  WHERE DID YOU OBTAIN DelEx? ______________________________________________
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  36.  COMMENTS:
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