	Super Retriss 3.0 REGISTRATION FORM
	===================================          DATE : [   /   /   ]

	NAME : [                                                        ]

	STREET & NUMBER : [

	                     ]  PHONE NUMBER (optional) : [             ]

	CITY : [             ]  STATE : [    ]  ZIP CODE : [            ]

        COUNTRY : [                                 ]
        _________________________________________________________________

      	CPU :  88/86( ) 286( )  386SX( )  386( )  486SX( )  486( )  P5(?)

        CPU SPEED(IN MHZ): 8( ) 10( ) 16( ) 20( ) 25( ) 33( ) 50( ) 66( )

        NUMBER REPORTED BY  sretriss.exe /s : [    ]

	IS THE GAME !!TOO!! FAST ON LEVELS 9 AND 10? [                  ]

        HAVE YOU TRIED DIFFERENT SPEED SETUPS USING THE -P SWITCH? IF SO,

        WHAT NUMBER WORKS FINE WITH YOUR COMPUTER? [                    ]

	MOUSE : NO( )  YES( ): [                                        ]

        PROBLEMS WITH THE MOUSE SO FAR? [                           ->BACK

	SOUND CARD: NO( )   SOUND BLASTER( ) / PRO( ) / 16( )
	            ADLIB( )/GOLD( )  GUS( )   PAS( )   OTHER: [        ]

        PROBLEMS WITH THE SOUND BLASTER SO FAR? [                   ->BACK

	HOW WOULD YOU GRADE SUPER RETRISS (0-LOWEST, 10-HIGHEST) : [    ]

	WHERE DID YOU OBTAIN THIS PROGRAM ? [                           ]

	USE BACK OF THE SHEET FOR ANY COMMENTS OR SUGGESTIONS, THANK YOU.
        -----------------------------------------------------------------

        CUSTOM TEXT FOR YOUR REGISTERED PROGRAM (MAXIMUM OF 20 CHARACTERS)

	: [                                                              ]

						 MARK WHERE
					         APPLICABLE

	BASIC REGISTRATION                   $10 :  [  ]   $.......
        SPECIAL R. 1 DISKETTE  3( )  5( )  $20 :  [  ]   $.......
	SPECIAL R. 2 (diskette included)     $15 :  [  ]   $.......
        S&H OUTSIDE CANADA AND U.S.          $5  :  [  ]   $.......

	      			  TOTAL AMMOUNT ENCLOSED : $.......
