		 CRYPTOSOLVE 1.0 Copyright 1996 James A. Parsly
			    All rights reserved.

			     REGISTRATION FORM

Registering entitles you to guilt-free use of the software. Also, I am
more likely to pay attention to your complaints and suggestions if you
send me money. 


Name ______________________________________________________________________

Address ___________________________________________________________________

City    __________________________  State/Province ________________________

Country __________________________  Zip (Postal) code _____________________

Optional:  E-mail address _________________________________________________

Where did you get your copy?         

    [ ] BBS     Which one? ________________________________________________

    [ ] Internet/FTP  Which site? _________________________________________

    [ ] Other _____________________________________________________________

What do you want me to spend the money on?

[ ]  Beer   [ ] Video Games   [ ] Gifts for Wife   [ ] Donate to Charity
[ ]  Other ______________

								    Total

Registration ................................................   $   10.00

I have enclosed    [ ] Check    [ ] Money order    [ ] Cash
    (Sorry, but I cannot accept payment by credit card.)


Comments or Suggestions:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Please return this form with your payment to:

	James A. Parsly
	624 Summit Lake Court
	Knoxville TN 37922

