The Bill Drawer - Registration Form - Version 1.12 


   Name: ________________________________________________________

Company: ________________________________________________________

Address: ________________________________________________________

         ________________________________________________________  

   City: ________________________  State:_____  Zip:_____________ 


Check One: Individual (  )  Company (  )  Other:_________________ 

Disk Size: 5 1/4 (  )   3 1/2 (  )  

Source of Program: ______________________________________________
                         (Name of BBS, Catalog, etc)  


Check Desired Registration Options:

(  ) Registration Only - $15.00 (US) 
     Includes current diskette, user guide, and notification of new 
     releases.

(  ) Phone Support - Additional $30.00 (US) for two hours maximum usage.
     Check and we will send you a support agreement, which you may review 
     and then decide whether or not you wish to purchase the support.  

(  ) Source Code - Additional $75.00 (US) for Visual Basic Source.
     Check and we will send you a source code agreement, which you may
     review and then decide whether or not you wish to purchase the source.  
     

Total Amount Enclosed: _____________ 
(California residents, please add appropriate sales tax)   


Remit To:  MelissaSoft Systems
           11676 Windcrest Lane
           San Diego, CA 92128

Orders Outside the US: Check must be drawn on US bank in US dollars.