Thank you for registering E-Clean!

Send the $10.00 registration fee along with the following information to:

John Decker
14344 Park Avenue South
Burnsville, MN 55337

Registration Information
========================

Name:		_____________________________________*

Address:	_____________________________________*

		_____________________________________*

City:		_____________________________________*

State:		_____________________________________*

Zip:		_____________________________________*

E-Mail Address:	_____________________________________*

Daytime Phone:  (________)________-__________________

Evening Phone:  (________)________-__________________

E-Clean Version:  1.0.1                              *

* Denotes required information