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                            REGISTRATION FORM
                  Little Digital Talking Clock ver. 1.5
                 Copyright (c) 1997 by Gary L. Robinson
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                        CASH, CHECK or MONEY ORDER
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    Please complete the following information and return this form with your 
    check or money order to the address below.  Please make all checks and 
    money orders for funds payable to Gary L. Robinson.  

    Current U.S.A. price is $10.00 for a single copy.  $15.00 if you
    require a disk with the current version.  Please contact me for aditional
    information on multiple registration price listings or for foreign orders.

    Please submit to:  Gary L. Robinson
                       P.O. Box 359
                       Christiansburg, OH 45389-0359
                       USA
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    <Please Type or Print Clearly>
    
    Name: ___________________________________________________________

    Address: ________________________________________________________

             ________________________________________________________

    City: _____________________  St or Prov: ________________________

    Postal Code: ________________  Country: _________________________

    E-Mail address: ________________________________

    Date: ___-___-______
    
    I would like to register:                            Totals

    ____ Copy(s) of L.D.T.C.  @ ____ per copy:        $___________________

    OHIO Residents add %6.5 for state sales tax:      $___________________

    I am including a check or money order for:        $___________________

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