R E G I S T R A T I O N   F O R M
                     =================================
                              Kurt W. Dekker
                              P.O. Box 10342
                           Costa Mesa, CA  92627

Ship To:  _______________________________ (Name)

          _______________________________ (Address)

          _______________________________ (Include Zip!)

Phone:    (______)_______________________

+=========================================================================+
| Product Name/Description                       |   Price     |  Total   |
+================================================+=============+==========+
| ROX - Blast Rocks In Outer Space               |    $10      |          |
+------------------------------------------------+-------------+----------+
| SCUD - The Missile Command Game                |    $10      |          |
+------------------------------------------------+-------------+----------+
| KSI - Kurt's Spaced-Out Invaders               |     $5      |          |
+------------------------------------------------+-------------+----------+
| VIPER - the Serpentine Game                    |     $8      |          |
+------------------------------------------------+-------------+----------+
| ACK - Ack-Ack Attack; Parachutist's Nightmare! |     $8      |          |
+------------------------------------------------+-------------+----------+
| GAL - Galaxy Invaders - coming soon!           |     $8      |          |
+------------------------------------------------+-------------+----------+
| DSM - Deep Space Mission - coming soon!        |     $8      |          |
+------------------------------------------------+-------------+----------+
|                                                |             |          |
+------------------------------------------------+-------------+----------+
|                                                |   TOTAL:    |          |
+================================================+=============+==========+
                                         (CA Residents Add 7.75% Sales Tax)

I strive to make playable and enjoyable arcade games for the PC compatible
line of computers.  If you would take just a moment to provide me some
feedback on the game you play tested, I will send you a FREE UPGRADE if I
make the suggested modifications/improvements!

1.    What game(s) did you play?_____________________________________

2.    Please rate the following areas from 1 (lowest) to 5 (highest):

                                             Lowest                 Highest
            Graphics                           1     2     3     4     5   
            Sound                              1     2     3     4     5   
            User Interface (scoring, etc.)     1     2     3     4     5   
            Documentation/Help                 1     2     3     4     5   

Thank you very much for your feedback!