Registration form for PFReq
                      ---------------------------


  Name:    ______________________________________________________________

  Address: ______________________________________________________________

           ______________________________________________________________

           ______________________________________________________________

  Country: __________________

  Phone:   __________________

  FAX:     __________________

  EMail:   ______________________________________________________________

           ______________________________________________________________

           ______________________________________________________________



  I am sending the shareware fee via (please mark/delete as appropriate):


           o    DM  15.- in bills, coming with this letter.

           o    US$ 15.- in bills, coming with this letter.

           o    EuroCheque, coming with this letter.

           o    Postal Money Order.

           o    Bank transfer.



   I have read the license and distribution details and agree with them.



    _____________________  ____________________________________________
          (Date)                         (Signature)