Poker Registration form

 

 

Print this form and mail along with a Check or money Order for $14.99 US Funds, to:

 

 

 

Matthew Benjamin

1695 NE 230th

Troutdale, OR 97060

 

 

Once payment is received, Registration code will be sent within 24 hours.

 

 

Also available on CDROM or FLOPPY diskette for $19.99. You will receive a registration code in your

E-mail for instant use, and you also will be mailed a fully functional backup version on CD-Rom or floppy disk.

(Address required US residents only). If ordering backup copy, please specify one of the following.

CDROM________________FLOPPY________________

 

 

Make checks payable to Matthew Benjamin. Fields marked with an * are required. E-mail address is

needed to send you your registration code and will not be used for any other purpose.

 

 

*Name ______________________________________________________________________________

 

 

*Serial #_____________________________________________________________________________

(Serial # is located on Registration nag screen and under the "Help\About" menu in MultiPay Poker)

 

Address _____________________________________________________________________________

 

____________________________________________________________________________________

 

*E-Mail _____________________________________________________________________________

 

Do you wish to receive notifications of free updates? Yes__________ No__________

 

Suggestions or Comments_____________________________________________________________

 

____________________________________________________________________________________

 

____________________________________________________________________________________

 

____________________________________________________________________________________

 

 

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