Please fill out this form completely and mail along with a check or
money order for the appropriate amount to:

                        Richard L. Rouse
                       Route 1,  Box 303D
                     Glade Spring, VA 24340


Customer's Name: _______________________________


Address: _______________________________________

         _______________________________________

         _______________________________________


Phone (optional): ______________________________



How did you obtain a copy of GRADER? _______________________________________

____________________________________________________________________________

____________________________________________________________________________


You wish to register (check one):      a) Single Copy  ($25)  _______   
                                       
                                       b) Site License ($75)  _______


Are there any changes or enhancements that you would like to see made to the
GRADER software package? If so, please describe in the space provided:

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________


Thank you very much for registering your GRADER software.  I appreciate it
very much.

                 Richard L. Rouse

