ViewFX Ver. 2.x -- Individual User Registration Form

1. User information:

Name: _______________________________________________________________________
Address: ____________________________________________________________________
City: ___________________ Prov/State: _____________ Postal/ZIP: _____________
Country (if other than CANADA):______________________________________________
Phone number: (___)______________ Date (MM/DD/YY): ____/____/________________
E-mail address (optional): __________________________________________________

2. Choice of registered version (check one):

__ ViewFX Shareware DOS
__ ViewFX PRO DOS

3. Shipping and Handling (check one):

__ E-mail uuencoded file to: ____________________________________
__ 3.5'' DS/HD disk

4. Payment and fees:

Fees are in U.S. dollars, please do not send cash. Checks and
money orders must be made payable to TOR Computerized Systems Inc.
Select form of payment (check one):

__ Enclosed check or money order in U.S. dollars
__ Credit card payment: ___ VISA   ___ MasterCard __AMEX
   Card Number: ______________________________
   Expiration Date (MM/YY): ____/____
   Cardmember signature (required): ______________________________

Check all that apply and fill in the blanks:

__ One registered copy of ViewFX 2.x PRO or newer....................$69.00
__ One registered copy of ViewFX 2.x or newer........................$29.00
__ Canadian Shipping and handling (if other than E-mail)..............$5.00
__ USA Shipping and handling (if other than E-mail)...................$9.00
__ Outside North America Shipping and handling ( other than E-mail)..$15.00

Total:...............................................................$_____

5. Mail this form together with payment to:

   TOR Computerized Systems Inc.
   Attn: Tony Uccello
   160 Applewood Cres., #14,15
   Concord, Ontario, L4K 4H2
   CANADA

   Or: If credit card payment was selected, this form may be faxed to 
   905-660-1382 (Toronto, Canada) or E-mailed to sales@torcomp.com.
