VPIC REGISTRATION/ORDER FORM

        The following includes material, postage and handling for all
        disk orders; $5 inside, $10 outside the USA and Canada for 1
        disk. If you would like additional disks, please add $5/disk.

        I would like to:
        ___ register my current VPIC version (enter number) _________ ($15).

        ___ register my upgrade from VGIF to latest VPIC ($5).

        ___ register & order the latest version of VPIC.
            $20 inside ($25 outside) the USA and Canada.

        ___ Upgrade from VGIF & order latest version of VPIC.
            $10 inside ($15 outside) the USA and Canada .

        ___ get update to latest version of VPIC.
            $5 inside ($10 outside) the USA and Canada.

        ___ Other: _______________________________________________________

        For your records, my equipment is:
            Display Adapter: Manufacturer _________________________________
                                    Model _________________________________

            I can view  EGA               (640x350x16 colors) _______
                        VGA  (EGA + 640x480x16 + 320x200x256) _______
                        SuperVGA (VGA with higher resolution) _______

            Highest resolution I can view in 16 colors is _______________
            (ie, 640x480, 800x600)   and in 256 colors is _______________

            My 5.25" Disk Drives are ____ 1.2M, ____ 360K

        Name:             _________________________________________________
        Address:          _________________________________________________
        City, State, ZIP: _________________________________________________
        Phone:            _________________________________________________

        Comments: _________________________________________________________
        ___________________________________________________________________
        ___________________________________________________________________
        ___________________________________________________________________
        ___________________________________________________________________
        ___________________________________________________________________
        ___________________________________________________________________
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        Please send the completed form along with payment by cash, check, or
        money order (no PO's please) to:

            Bob Montgomery
            543 Via Fontana #203
            Altamonte Springs, FL 32714-3172

        PS: For foreign orders, please send a check drawn on a US Bank, US
            Postal or International Money Order, Travelers Checks, or cash,
            since the banks here charge $25 collection fee for foreign checks.