
            _______________________________________________________
           |                                                       |
           |                                                       |
           |           BEST BIORHYTHM REGISTRATION FORM            |
           |                (Please print or type)                 |
           |                                                       |
           |                                                       |
           |  NAME OF                                              |
           |  REGISTRANT________________________________________   |
           |                                                       |
           |  ADDRESS __________________________________________   |
           |                                                       |
           |  CITY___________________ STATE & ZIP_______________   |
           |                                                       |
           |  COUNTRY_______________                               |
           |                                                       |
           |      Registered owners may sell or give away the      |
           |      printouts generated by the Best Biorhythm        |
           |      program.                                         |
           |                                                       |
           |      Registration fee of $10.00 enclosed.             |
           |                                                       |
           |           CHECK____   MO____   CASH____               |
           |                                                       |
           |      Make check or money order payable to:            |
           |                                                       |
           |                 L. W. Brenneman                       |
           |                                                       |
           |      Mail to:   Forecasts                             |
           |                 P.O. Box 10665                        |
           |                 Erie, PA 16514                        |
           |_______________________________________________________|
           |                                                       |
           |  This part is optional:                               |
           |                                                       |
           |  How did you receive Best Biorhythm? (Check one)      |
           |                                                       |
           |     From a BBS_______     A friend _______            |
           |                                                       |
           |     A mailorder shareware dealer   _______            |
           |                                                       |
           |     A local computer store         _______            |
           |                                                       |
           |     Name of BBS, dealer or store (still optional)     |
           |                                                       |
           |     _______________________________________           |
           |                                                       |
           |     Thank you                                         |
           |_______________________________________________________|


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