REGISTRATION APPLICATION FORM
--------------------------------------------------------------------
ASTEC 1705 Naudain St., Philadelphia, PA. 19146 U.S.A
Please mark the options that apply to your order.
All prices in Dollars;
please add $2 if paying with a non-French cheque or in another currency.
--------------------------------------------------------------------
French resident, send 100FF to :
Ollivier CIVIOL
11 Rue S. Verninac
19100 Brive.
--------------------------------------------------------------------

(   )	Please register my copy of SzipW v1.x for $20
 	(add $2 for shipping and handling)

(    ) - I need a receipt please. 

Site licenses:  
A site license for SzipW entitles an organization to receive one copy of the distribution package and duplicate the distribution disk for the specified number of copies.

SzipW Single Copy     ____   	 copies at $20 each =    ______

SzipW Site License
  2 to   9 computers: ____ 	computers at $18 each =  ______
 10 to  24 computers: ____ 	computers at $15 each =  ______
 25 to  49 computers: ____ 	computers at $12 each =  ______
 50 to  99 computers: ____ 	computers at $10 each =  ______
100 to 199 computers: ____ 	computers at $7  each =  ______
Pennsylvania residents add 8% sales tax        	       + ______
                         Total payment                   ______

I got SzipW from ____________________ 


Name	_____________________________________

Company	_____________________________________

Address	_____________________________________

	_____________________________________

	_____________________________________ (Include postal code)


Phone	__________________________

Fax/e-mail   _________________________

Payment 	(     )  Cheque payable to OLLIVIER CIVIOL

I agree to the Disclaimer and Shareware Conditions in the Help file.

Signature		____________________________________