			REGISTRATION FORM

			PIAF, INC.
			3918 ORCHARD COURT
			BOULDER, CO 80304-1023
			(303) 786-8222

1) Circle a Registration Option:

OPTION 1 - $69 (plus $6 s&h US, $15 s&h outside US)
    Registered Surefire (latest version) disks plus 6 months technical
    support, 460 page user's guide, demonstration and practice documents.

OPTION 2 - $29 (plus $4 s&h US, $8 s&h outside US)
    Registered Surefire (latest version) disks plus 2 technical support
    calls, 3 months tech support by mail and demonstration Smart Documents.

2) Circle Disk Size:     5 1/4"         3 1/2"

3) Check here [] to register Surefire Contacts    $19 (plus $4 s&h US
   $8 s&h outside US)
   Note: If you have not already registered SUREFIRE you must choose
   option 1 or 2 above along with this one.

	TOTAL AMOUNT ENCLOSED:  $____________ (Colo res. add 3% tax)

VISA or MC #:________________________________________

EXPIRATION DATE:______/_______ SIGNATURE___________________________

Please make checks payable to : PIAF, INC.  (U.S. funds only)

4) Please fill out below:

NAME____________________________ TITLE_______________ DATE__________

COMPANY_______________________________________  PHONE_______________

ADDRESS_____________________________________________________________
       _____________________________________________________________

CITY____________________________________ STATE_______ ZIP___________

COUNTRY _______________________________

5) Please answer these questions:

    1. Your industry?_________________ 2. Job function? ______________

    3. Will you use Surefire at home or work? ________________________

    4. Number of PCs at this location? ____ Is there a network? ______

    5. Where did you learn about Surefire? ___________________________

    6. Where did you get your shareware copy of Surefire? ____________

    7. Comments (use back for more room)
    __________________________________________________________________
    __________________________________________________________________
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