TRANSFER Registration form  (Worldwide)

Remit To:           Stephen Lewis                 VOICE: 415-469-6604
                    405 South Sunnyvale Av
                    Box 210
                    Sunnyvale, CA 94086

    DSZ Quantity Discount Schedule, (per purchase).  Each:

      1       $15.00   2-4     $14.00   5-49    $13.00   50-99   $11.00
      100-199 $9.00    200-499 $ 7.00   500-999 $ 6.00   1000+   $ 5.00


              TRANSFER registrations & 1 Disk (5.25 in)            ______

              3.5 inch disk instead of 5.25 inch ADD $ 5.00        ______

                                                            Total  ______

-----------  INSTANT SINGLE QUANTITY REGISTRATION (Circle one) -----------

        5.25" check enclosed   $15.00       3.50" check enclosed   $20.00

Use Address on envelope ( )    check ( )    or:

Name     ___________________________________________________________________

Address  ___________________________________________________________________

         ___________________________________________________________________

         ___________________________________________________________________