Send check or postal order in name of Carlos Miguel Salas Gonalves Batista 
to:

                     Carlos Gonalves Batista
                     Av. Aviao Portuguesa, 23 - 1 Drt
                     2700 Amadora * Portugal

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Complete Name: ____________________________________________________

Adress: ___________________________________________________________

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ZIP Code: ____________________________

Country:_____________________________________

Phone Number: _____________________

Where did you get MailDB? : _________________________________________

Processor type: [ ] i8086  [ ] i8088   Video Card: [ ] Hrcules    [ ] CGA
                [ ] i80286 [ ] i80386              [ ] EGA         [ ] XGA
                [ ] i80486 [ ] Pentium             [ ] VGA or SVGA
                [ ] Other                          [ ] Other

Operating System:  [ ] MS-DOS x.x  [ ] DR-DOS x.x        [ ] Other
                   [ ] OS/2 x.x    [ ] Windows NT ou x.x

Offline Mail Reader [ ] OLX/SLMR(tm)  [ ] MegaMail(tm)   [ ] Other
that you use:       [ ] Deluxe(tm)   [ ] Blue Wave(tm)
                    [ ] Ez-Reader(tm) [ ] Power-QWK(tm)

Comments: _________________________________________________________
___________________________________________________________________
___________________________________________________________________

I understand that this software is supplied without warranty, express or
implied, and agree not to hold its author liable for any direct or
consequential loss arising out of my use of it.

Signature: _________________________________________________________


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>>>>FOR INTERNAL USE! DO NOT FILL!<<<<

Data de Recepcao: ___/___/____
N/ Referencia: __________
Nome de Registo: ____________________
Numero de Registo: [______]

                                             _____________________

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>>>FOR INTERNAL USE, DO NOT FILL!<<<<

Date: ___/___/____
Register Expression:[___________________]
Register Number: [______]

Author Signature:  __________________________________________________

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