CONTACT 3.21
            
                                    USER REGISTRATION/COMMENT FORM
            
            
            USER IDENTIFICATION (Please type or print)
            
            Full Name: ______________________________________________  Date: _____________
            
            Organization: ______________________________________  Dept.: _________________
            
            Street/Box Address: __________________________________________________________
            
            City: ________________________  State/Province: _____  Postal Code: __________
            
            Telephone:  Home - (______)_________________  Work - (______)_________________
            
            
            SYSTEM CONFIGURATION
            
            Computer Brand and Model: ____________________________________________________
            
                     Configuration: ______________________________________________________
            
            MS-DOS Version: __________  IBM PC Emulator and Version: _____________________
            
            Printer Brand and Model: _____________________________________________________
            
            
            PLEASE COMPLETE THE APPROPRIATE SECTION(S) BELOW
            
            1.  REGISTRATION
            
            Please register me as a legal user of CONTACT.  My payment of $_______________
            ($10.00 minimum) is enclosed.  I understand that registered users are entitled
            to software support and notification of new releases.
            
            Checks or money orders should be made payable to "Orion E. Hill."
            
            2.  SUGGESTIONS, QUESTIONS, PROBLEMS, AND/OR OTHER COMMENTS
            
            Please describe in as much detail as possible.  Use the other side of this form
            and/or attach additional sheets as necessary.
            
            ______________________________________________________________________________
            
            ______________________________________________________________________________
            
            ______________________________________________________________________________
            ==============================================================================
            
            Please mail this form to:  Orion E. Hill
                                       361 Pickwick Drive
                                       Napa, California 94558-6101