TETRIS-PENTIS Registration Form

Please complete this form, print it, and enclose your payment in US funds
in a check or money order.
NO CREDIT CARDS ACCEPTED.

The registration fee is $10 (US).
Handling & Shipping is $5 (US).

Remenber that you can order directly by CompuServe (SWREG Forum) and receive
directly by E-Mail the last version and the licence files without paying the
Handling and Shipping $5 (US). (Registration ID: 7343)


Name       ______________________________________________________


Address    ______________________________________________________


City       ______________________________________________________


State      _______________________  Zip _________________________


Number of Licenses   _________
                  
                     _________
                               total


   Emil Fickel
   Walramstr.29
   65183 Wiesbaden
   GERMANY

  CompuServe: 100645,1340
  Internet:   100645.1340@COMPUSERVE.COM
