Date Calculator Registration FORM

  First you must print this form out going to the Help menu and 
  Clicking on Print Registering Info  Next fill out the info
  below, total your order, and mail this form and your check or 
  money order in US dollars.






  Make Payment to:
	Mike Bechtold

  And Mail To:
	HOMEWORK INC.
	7154 72nd Lane #249
	Brooklyn Park, MN 55428



     Name: _______________________________________________

  Address: _______________________________________________

	   _______________________________________________

    Phone: ______________________

  E-Mail:  ______________________







   Item                               Each       Ext. Cost
   ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~   ~~~~~~     ~~~~~~~~~

       Date Calculator Registered     $9.95     _________

       Sales Tax                                _________
	    (6.5% Minnesota residents Only)

       Total Including                          _________