AmiWin Registration Form (November 95)
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Please fill out this form and send it to:

 Holger Kruse
 12006 Coed Drive
 Orlando, FL 32826
 USA


Please mark one item in each category and add up the prices:



1.   AmiWin registration fee:                            US$  50.00  [ ]

     Free Upgrade from earlier versions of registered
     AmiWin (Ser #: xx-xxxxx)                            US$   0.00  [ ]


2.   Media costs          880 kB DS/DD floppy disks:     US$   5.00  [ ]

                         1.76 MB DS/HD floppy disks:     US$   3.00  [ ]
                         
          2 GB DAT (DSS) tape tar-format (512 B/bl):     US$  10.00  [ ]
          
                               100 MB ZIP cartridge:     US$  20.00  [ ]



3.   Shipping/        within the USA, priority mail:     US$   4.00  [ ]
     packaging
                       to other countries, air mail
                                        on DD disks:     US$   7.00  [ ]
                                        on HD disks:     US$   4.00  [ ]
                                        on DAT tape:     US$   3.00  [ ]
                                   on ZIP cartridge:     US$   4.00  [ ]

     Other shipping arrangements are available upon
     request.


                                              Total:     US$ ______



- I have enclosed the above amount in [ ] cash, [ ] check, [ ] money order.


- Please charge my First Virtual account ID ___________________________

  I agree to confirm the corresponding transaction to First Virtual and
  to allow First Virtual to charge the above amount to my credit card.

Please fill in your shipping address and give me some information
about your system. The information you provide will be treated
confidentially.


Name:         ________________________________________________

Street:       ________________________________________________

City, ZIP:    ________________________________________________

Country:      ___________________  Phone: ____________________

E-Mail:       ________________________________________________


Amiga model:  ___________________    CPU: ____________________

Networking software: _________________________________________

Graphics boards / chipsets: __________________________________


I would like to become a registered user of AmiWin and obtain
a non-exclusive single-site license. Please send me my keyfile
and the latest program version.


I agree to keep the keyfile and all parts of the AmiWin package
secret, and acknowledge that disclosure of the keyfile or any
part of the AmiWin package or tampering with the keyfile is
considered software piracy and terminates my license.


_____________________________     ____________________________

(city, date)                      (signature)