

                 Name:_____________________________________________________

      Mailing Address:_____________________________________________________

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            Disk Size:[ ] 5-1/4" 1.2MB   [ ] 3-1/2" 720K   [ ] 3-1/2" 1.44MB

          Type of CPU:[ ] 808x           [ ] 80186         [ ] 80286
                      [ ] 80386          [ ] 80486         [ ] Pentium

         Speed of CPU:_____________________________________________________

      Protected Mode?:[ ] Yes            [ ] No

Unregistered Version?:[ ] Yes            [ ] No

    Student Discount?:[ ] Yes            [ ] No

 Registration Amount?:[ ] $20 (student)  [ ] $40 (normal)
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