
                              ImageDex Registration

               Send to:       Precision Imagery
                              P.O. Box 20676
                              Cranston, RI 02920
                              USA

------------------------------- Cut here 8< -------------------------------



______    ImageDex Registration fee............. @ US$10.00 ea. $ _________


          SHIPPING & HANDLING  

          North America: $1;   Outside: $3                      $ _________



                                                       SUBTOTAL $ _________



         Rhode Island residents add Sales Tax......@ 7% (ouch!) $ _________



                        TOTAL (U.S. funds drawn on a U.S. bank) $ _________



Name: _____________________________________________________________________

Company (ONLY if company address): ________________________________________

Address: __________________________________________________________________

         __________________________________________________________________

         __________________________________________________________________

  Phone: _________________________



Problems, bugs, compliments, suggestions, flames: _________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________



