

     To

     Dirk Dsterberg
     Jahnstr. 9
     31860 Emmerthal
     Germany
  



     I want to become a registered user of "PICSim". Registered Users
     get our PICAsm free if ready and spezial prize for the PICProgger.


     My address is:

     Name:     ________________________________________________________

     Address:  ________________________________________________________

               ________________________________________________________

               ________________________________________________________

     Country:  __________________

     EMail:    ________________________________________________________

     Hardware: ________________________________________________________

               ________________________________________________________


      It will be sent on 3.5" DD disk to the postal address. I am
      sending the shareware fee as (please mark as appropriate)



           o  Postal Order (excluding Postal Money Orders from the USA
              or Canada, see above) over DM 120,-, coming separately



		Dirk Dsterberg
		Jahnstr. 9
		31860 Emmerthal
		Germany
  



           o  Order/Bank Draft from outside Germany over
              DM 135,- / US$ 90, included with this letter



		Name      : Joannis Petroglu
                Institut  : STADTSPARKASSE BAD PYRMONT
                BLZ       : 254 513 45
                Konto-Nr. : 10346708


		(please note your Name and your EMail address on your Draft)







     I have read the section "Copyright" in the manual and agree with
     the conditions. Specifically, with my signature, I commit on
     installing the Program only on one computer and not giving it
     to others.



     _____________________  ___________________________________________
            (Date)                          (Signature)
