Shareware Registration Form
===========================

I want to register for the below selected Shareware products to get the full
versions and agree with the disclaimer, copyright, usage and distribution
conditions stated in the documentation.

Important note: The universal modules for ImageFX, Photogenics and XiPaint
  CAN ONLY BE ORDERED TOGETHER WITH THE PACKAGE of PhotoAlbum&CyberShow Pro
  (picture management and slideshow presentation and viewer software for
  all Amigas with at least OS3.0)! Separate module orders are not possible!

I send this form to:                    My address is
--------------------                    -------------

   Helmut Hoffmann                      Name:

   Rubensstrasse 4                      Street:

   D-41063 Moenchengladbach             City:
					State / Zip-Code:
   Germany
                                        Country:
                                        EMail:
                                  SFr
Payment:                          Aus$ |     |     |     | DKr |     |
                                  Can$ |     | IR£ | FMk | NKr |     |
                                   DM  | US$ | GB£ | FFr | SKr | HFl |  LIT
  For complete package consisting of PhotoAlbum and CyberShow Professional
   (picture manag.&present.):-> X  50  |  35 |  25 | 180 | 250 |  60 | 60000

  in addition for ImageFXMod.:  O  10  |   7 |   5 |  40 |  50 |  10 | 11000
  in addition for XiPaintMod.:  O  10  |   7 |   5 |  40 |  50 |  10 | 11000
  in addition for UniversalGIO: O  10  |   7 |   5 |  40 |  50 |  10 | 11000
  (Module orders only possible in conjunction with complete package order!!)


  Total price:              ___DM,C$,A$ ___US$  __£  ___F ___Kr __HFl _____L

  O I included banknotes or a cheque (e.g. EuroCheque or bank order cheque)
  O I payed with international postal money order cheque


Location/Date:__________________    Signature:________________________
-> Please do not forget your signature, as otherwise your order can be
   delayed until you have sent a signed registration form! <-

I am currently using XiPaint module demo version 5.4a which I got from
O CD-ROM "___________"     O AmiNet                     O PD-Disk "________"
O a friend                 O a BBS or Mailbox           O __________________

System configuration: Amiga:_____   or Draco:_____
  CPU: 680__ with ___MHz            ChipMem: ___MByte  FastMem: ___MByte
  Graphic board: ________________   Framegrabber: _________________________
  Motion video board: ___________   Scanner: ______________________________
Amiga-OS: __.__ (at least OS3.0!)   CyberGraphX: _________ (optional)

Painting and Image Processing programs:
Comments/Suggestions: