REGISTRATION FORM

       Registration    entitles  the  user  to  full   support,   major
       upgrade  notifications,  discounts on all  programs  and  future
       programs.

                               VIDEO POKER SLOT            
                          Version 4.OO Registration 

                              Please specify disk size

       Registration Fee        ( ) 5 1/4"  ( ) 3 1/2"           $ 15.00

                                              Shipping/Handing  $  3.OO 

                                   Foreign orders add   $ 5.OO  _______
       Foreign Orders on International Money Orders
       or Credit Card payable in US funds.
                                              Total          $  _______


       Method of Payment:  ( ) Check/Money Order
                               Drivers Lic. # _________________________

                           ( ) MasterCard      ( ) VISA

       Credit Card #  _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _

       Exp. Date      _ _ - _ _

       Name on Card   _____________________________________

       Signature      _____________________________________ 
                         Required on Credit Card Orders

                     Make Checks/Money Orders payable to:

       United Innovations Plus, P.O.Box 21O81, Castro Valley, CA 94546

       Phone Order #: 510-886-9036      Fax Order #: 510-886-0818

       SHIP TO:

       Name     _______________________________________________________

       Address  _______________________________________________________

       City     _____________________________ St. ______ Zip __________

       Phone # (Optional) _ _ _ - _ _ _ - _ _ _ _

       Where did you acquire this program? ____________________________

        For our records, please indicate your systems display adapter.

       ___MONO  ___CGA  ___EGA  ___VGA  ___SVGA    Mouse ___Yes   ___No