___  __  ___   ___  ___   _____  __
 /   |/ / /   / /   |/   / / _  / /  \
/_/|___/ /___/ /_/|__/|_/ /_//_/ /___/  o o o

registry form for Nomad's Quick Dice Roller v3.1

First Name:______________________  Last Name:_________________________

Middle Initial:___                 Age:___  

Type Of Computer:_____________________________________________________

Address:______________________________________________________________

        ______________________________________________________________

Phone Number:(___)-___-____

E-mail address:_______________________________________________________

Home page: http://____________________________________________________

Payment Method (select one):  O Check      
			      O Money Order    (no cash in the mail)

Program Transfer Method (select one):  O Snail Mail to above address*   
				       O E-mail

If the program is to be sent via Snail Mail it will cost an additional $2.00 s&h

Make Check or Money order payable to Damon Truitt

For snail mail orders			For e-mail orders
--------------------------------  	-------------------------------
   Registration Fee:       $5.00	   Registration Fee:	  $5.00
Shipping & Handling:       $2.00				  -----
			   -----				  $5.00
			   $7.00

I have enclosed the above amount for the registered version of this software, please send it ASAP.

___________________________________ 
			  Signature

___________________________________
			       Date				

Expect 2 to 3 weeks by snail mail or 2 to 3 days by e-mail
Nomad Software 1997

    Source: geocities.com/SouthBeach/9077

               ( geocities.com/SouthBeach)