



                          CodeSMART Registration Form





 Please print this document, answer the questions and send it along with
 the registration fee - cash or check.





 SECTION 1
 ======================================================================

      Product ID: _____________________
                  (From the CodeSMART about box)

            Name: _____________________________________________________

         Company: _____________________________________________________

         Address: _____________________________________________________

            City: _____________________________________________________

  State/Province: _____________________________________________________

     Zip/Country: _____________________________________________________

 Internet E-mail: ________________________





 SECTION 2
 ======================================================================

 Price list:

         1 copy: USD 30.00
     2-9 copies: USD 27.00 each
   10-24 copies: USD 25.00 each

 Note: for more than one copy you must provide an additional list
 including all CodeSMART Product IDs (every copy will have a separate
 registration key).

 For details of anything not specifically covered by the above price
 list please contact us at the following Internet e-mail address:
 idearo@fx.ro

 The registration sum can be paid in cash or by check.

 Notes:
    - If you send cash: before inserting the money into the envelope,
      please put them in a folded piece of paper to counteract the
      envelope's transparency.
    - If you send a check: checks are ONLY accepted on the following
      condition: a surcharge of USD 11.00 applies (per check).





 SECTION 3
 ======================================================================

 Number of copies to register: _____________

 Total payment: ____________________________


 The registration key(s) will be sent to the Internet e-mail address
 specified above (in the first section of the present document).

 Checks or cash, as well as this document should be sent to:

      Name:             NEDELCU STEFAN
      Postal address:   CP 1-519
                        70700 BUCHAREST
                        ROMANIA

 User signature: ______________________________
