Registration form for Middle Mouse Button 1.9.1a

Name:____________________________________________________
Organization:____________________________________________
Address:_________________________________________________
	_________________________________________________
City:____________________________________________________
State or Province:_______________________________________
Postal code:_____________________________________________
Country:_________________________________________________
Phone:_______________________Fax:________________________
Email:	_________________________________________________

Registration options:

Single user registration and diskette [SWREG ID 7865] $10.00 + $5.00 shipping,
Number of copies of Mbutton on diskette required:________
Select desired disk format....   3.5"____ or  5.25"____

Single user registration [SWREG ID 15041]	$10.00.	Qty: ______
Five user registration [SWREG ID 15043]	$30.00.	Qty: ______
Ten user registration  [SWREG ID 15042] 	$50.00.	Qty: ______
Fifty user registration [SWREG ID 15044]	$200.00.	Qty: ______
100 user registration [SWREG ID 15046]	$350.00.	Qty: ______
500 user registration [SWREG ID none]	$1500.00.	Qty: ______

Payment methods:
If paying by check or money order, payment should be in US funds.
Make the check or money order payable to: Digital Control Systems.

You may register this program via Compuserve (GO SWREG)

We will also accept American Express, MasterCard or  VISA.
___ Check here to charge to your American Express account.
___ Check here to charge to your MasterCard account.
___ Check here to charge to your VISA account.

Name (as it appears on card):_____________________________________
Card Number:_______________________________ Exp date:_____________
Signature:________________________________________________________

If paying by credit card:
You may fax this form to (615) 889-9595.
You may send this form to this email address :  webmaster@digconsys.com
You may also call us at: (615) 889-6357.
Or you may use our Postal mailing address (required for check or money order):

Digital Control Systems
P.O. Box 505
Hermitage, TN. 37076-0505
USA
