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VideoArchiv - Registration                                  Version 3.0

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                                                       Date:___________

Name/First name:_______________________________________________________

Address  :_____________________________________________________________

ZIP      :____________ City:___________________________________________

Country  :_____________________________________________________________

EMail    :_____________________________________________________________

Amiga    :__________ OS-Version:__________ CPU:__________ RAM:_________


Notes:_________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

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Currency accepted:


New user:

  o CHF 20.- (Swiss, preferred)

  o USD 15.- (US)

  o DEM 25.- (German)


Registered user (update offer):

  o CHF 10.- (Swiss, preferred)

  o USD  8.- (US)

  o DEM 15.- (German)


Please select payment method:

  o Cash (include with registration form; no coins please)
         (please  note: we  cannot be  held  responsible  if, for  some
          reason, the money fails to arrive).


  o Bank draft

    Postcheque-account: 34-198422-8, Basel (Switzerland)


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Please send your details, letters, money etc. to:

                                David Rado
                              Höhlebachweg 32
                              CH-4132 Muttenz
                                Switzerland

                             drado@datacomm.ch