ProPrompt V1.30 Registration Form --------------------------------------------


Send Registration Fees To:    Scott Brown
                              P.O. Box 832
                              Larchmont, New York 10538


   Quantity             Description              Each        Total
   --------             -----------              ----        -----

   _____                ProPrompt 1.30           $20         ____

   _____                Shipping & handling..
                        $2.00 in US, $10 foreign             ____

   _____                3.5" disks       $10 per program     ____

   _____                NY Residents: Add appropriate
                        sales tax for your town/city.        ____


                                                 TOTAL:      ____

Date: _________________

Name: _______________________      Company: _____________________________

Street Address: ____________________________________   Apt #: __________

City, State: ____________________________ Zip Code: _________________

Country: _____________________

Days/Hours: ____________________________

How did you acquire ProPrompt? __________________

Comments?: _________________________________________________________________

Please send payment in the form of a check or money order made payable
to Scott Brown in US funds.


