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  1.                       EasyMake V1.00 Registration
  2.  
  3. Full Name:________________________________________
  4.  
  5. Address:__________________________________________
  6.  
  7. Address:__________________________________________
  8.  
  9. Province/State:__________________  Postal/Zip Code:_______________
  10.  
  11. Medium (5 1/4 or 3 1/2):____________
  12.  
  13. Usage
  14.  
  15. Personal [ ] , Bussiness [ ]
  16.  
  17. Amount Enclose : ____________________
  18.  
  19. ______________________________________________________________________________
  20.  
  21. Complete this form and mail to Shawn Sorichetti
  22.                                2 Bayberry St.
  23.                                Stouffville, ON.
  24.                                Canada
  25.                                L4A 7Z1
  26.  
  27.