Registration Form
 -----------------

      PerSuaSiVe SoftWorX

 To:  Andreas R. Kleinert       Fax +49-271-22869
      Sandstrasse 1                   (0271-22869)
      D-57072 Siegen
      Germany, Europe


 Currently used JPEG-Box Version ___________  (Library-Version _______)

 Found where ?  O Aminet  O Aminet-CD No. ___ O Other source: _________

 Full Name         : __________________________________________
 Street            : __________________________________________
 City, Postal Code : __________________________________________
 Country           : __________________________________________
 EMail             : __________________________________________
 Phone             : ___ _______ _______


 Registration includes a personal KEYFILE, which:

  O should be sent to the EMail adress as mentioned above, so I included
    25 DEM (15 U$)  [ please also see the "Discount" offers ]

  O should be sent via snail mail, so I included
    30 DEM (20 U$)  [ please also see the "Discount" offers ]

 (The PPC modules can be ordered fromout the SViewNG registration form
  or the "Discount" offer form.)

 The Shareware-fee comes as

    O included euro-cheque
    O included cash money
    O immediately following postal order
      (copy of bill included)
    O order cheque of german bank

 Additional information about my computer system (voluntarily, but
 helpful for support on errors) :

 My computer system consists on an ______________ with the following
 peripherals/expansions :
 ___________________________________________________________________
 ___________________________________________________________________
 ___________________________________________________________________
 ___________________________________________________________________

 I carefully read the documentation files of the program and I tested
 the program well, so that I am sure that the program will run without
 significant problems on my computer system.
 I do acknowledge, that the author of the program cannot be held
 responsible for any kind of damages or other problems directly or
 indirectly caused by the program (as also described within the
 program's documentation I already did read).
 So I included the shareware fee and decided to become a registered user
 of the program.

 I won't give my personalized keyfile away to anyone else.


  __________________________             _______________________________
  City, Date                             Signature