  ************************************************************************
  *                                                                      *
  *                        Jailbird - Version 2.5                        *
  *                 Copyright (c) 1993,94 by LB Software                 *
  *                                                                      *
  *                       Published exclusively by:                      *
  *                         RMH Computer Services                        *
  *                              PO Box  657                             *
  *                       Beech Grove IN 46107-0657                      *
  *                            (317)  782-9903                           *
  *                                                                      *
  ************************************************************************

Send registration form and payment to:

        Richard Holler
        RMH Computer Services
        PO Box 657
        Beech Grove IN 46107-0657
        USA

--------------------------------------------------------------------------

        I have enclosed ..(U.S. Funds)................... $19.00
             Others send International Money Order,
             US Funds, please.

        Indiana residents please add 5% State sales tax.. $_____

        Overseas residents please add $5.00 S/H ......... $_____

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

PLEASE PRINT

Name...: __________________________________________________________

Address: __________________________________________________________

       : __________________________________________________________

       : __________________________________________________________

Phone (required!)....: ______________________    Sales Code: JB250JCSM

I would like to receive:  [___] 3-1/2" disks (720k)
                          [___] 5-1/4" disks (1.2M only!)  

Do you have an email account" [Y/N] ___
   If yes, address: __________________________________________________

I received this program from: _____________________________________

___________________________________________________________________


CREDIT CARD ORDERS
------------------

For fast Credit Card (MC/VISA/DISCOVER) ordering, please call us at 
317-782-9903. Or, you can provide the information (including your 
signature!) in the space below. *ALL* spaced must be completed:

   +------------------------------------------------------------------+ 
   |    We can accept MasterCard, Visa, and Discover credit cards.    | 
   |                                                                  | 
   |           MasterCard [_]    Visa [_]     Discover [_]            | 
   |                                                                  | 
   | Credit Card Number:  ________  ________  ________  ________      | 
   |                                                                  | 
   | Name on the Card: _____________________________________________  | 
   |                                                                  | 
   | Expires: _______   Signature (*)________________________________ | 
   +------------------------------------------------------------------+ 
            (*) NOTE: This *REQUIRES* a hand-written signature! 


