
WinCtrl -- Site Registration Form

 
1. User information (please PRINT):
 
Company Name: ___________________________________________________
Site Address:____________________________________________________
City: ___________________ State: _______________ ZIP: ___________
Country: ________________________________________________________
Phone number: (___)______________ Date (MM/DD/YY): ____/____/____
Authorized representative: ______________________________________
Email address:___________________________________________________

 
2. Shipping and Handling (check one):
 
__ Email registration key to email address in (1) above.
__ Mail 3.5'' DS/HD disks to mailing address in (1) above
   (price within Croatia: 10Kn per disk, outside Croatia: $5.00
   per disk)
 
 
3. Check all that apply and fill in the blanks:

__ Sites IN Croatia:
__  1st computer at 30Kn:                               =    30Kn
__  2nd to 24th computer at 25Kn each: ..... ____ x 25  = _____Kn
__ Shipping and Handling ...............................= _____Kn
Total:................................................... _____Kn

__ Sites OUTSIDE Croatia:
__  1st computer at $10:                                = $ 10.00
__  2nd to 24th computer at $8 each: ...... ____ x 8    = $ _____
__ Shipping and Handling for computer disk ...............$  5.00
Total:....................................................$ _____


4. How did you get WinCtrl?

__ Downloaded from: _____________________________________________
__ Friend gave me
__ I found it on shareware CD-ROM: ______________________________
__ Other: _______________________________________________________


5. Mail this form together with payment to: 

   Eden Kirin
   Remetinecka 151
   10000 Zagreb
   Croatia, Europe


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Thank you for registering WinCtrl!

