


                              JupSat Registration Form


          Name:     _________________________

          Address:  _________________________
                    _________________________
                    _________________________
                    _________________________
                    _________________________

          I enclose payment for the following:

          Personal registration, 10              ____
          Club registration, 20                  ____
          Educational registration, 25           ____

          Additional materials:

          If non-EIRE/UK address, add 2:         ____
          If foreign currency, add 5:            ____

          Total Payment:                          ____


          Please indicate the disk format you would like:

          3.5" 1.44MB high density      ____
          3.5" 720k double density      ____
          5.25" 1.2MB high density      ____


          Please send this completed form, with your payment, to:

          Gary Nugent
          54a Landscape Park,
          Churchtown
          Dublin 14
          Ireland





          Payment:

          Payment may be made either in cash, or by cheque (made payable to
          "Gary Nugent").  I regret that I am unable to accept credit
          cards.  If you pay in a currency other than Irish punts or
          pounds sterling, please add to the total the equivalent of 5, to
          cover my costs of changing the money.

          If you do not live in Ireland or the UK, please add 2 to the total
          cost of your order, to cover the additional cost of air-mail
          postage.



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