DLL MASTER ORDER FORM

Please register me (us) as a licensed owner of DLL Master:

Name:           __________________________________________________

Company:        __________________________________________________

Address:        __________________________________________________

		__________________________________________________

City:           _______________________ State: ______ Zip: ___________

Country:        ___________________

Check Amount: $________________  Copies: ________  Date: _____________

    ( ) 5.25" disk   ( ) 3.5" disk

First acquired or learned about DLL Master from:
    ( ) Friend  ( ) Coworker    ( ) Catalog     ( )BBS:________________
    ( ) Other_______________________________________________________
								10-203

    Send to:    Shaftel Software
		3730 El Caminito Street
		Glendale, CA 91214