                                CRYPTO 1.2
                      Copyright 1994 Kenneth A. Reek
                           All rights reserved.

Registration and Order Form
---------------------------

Your name and address:

    Name    ____________________________________________________________

    Address ____________________________________________________________

    City    __________________________  State/Province _________________

    Country __________________________  Postal (zip) code ______________

    Phone (optional) (____)____-______

    Have you registered a previous version of CRYPTO?  [ ] Yes    [ ] No

    Where did you get your evaluation copy?

        [ ] BBS     Which one? _________________________________________

        [ ] CD-ROM  Which one? _________________________________________

        [ ] Friend

        [ ] Other ______________________________________________________


Registration: $US10

    I have enclosed [ ] Cash     [ ] Check     [ ] Money order

    (Sorry, but we cannot accept payment by credit card.)

    Preferred disk size:  [ ] 3 1/2" (1.44m)      [ ] 5 1/4" (1.2m)

                          [ ] 3 1/2" (720k)       [ ] 5 1/4" (360k)

Comments or Suggestions:

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Thank you for helping make the ShareWare concept work!
