------------------------------------------------------------------------------
         Alt-N Technology MDaemon Server v2.1 Registration Procedure
------------------------------------------------------------------------------

Always check http://www.mdaemon.com for the latest registration information,
procedure instructions, and product updates.

The following methods are available for registering MDaemon Server v2.1
and obtaining a full version registration key:

1) A secure version of this order form can be found at the MDaemon Server
   homepage (http://www.mdaemon.com).  If you use that form then you don't
   need to do anything with this one.

2) Complete and email this registration form to sales@mdaemon.com

3) Contact sales@mdaemon.com for alternative registration methods such as
   fax or phone orders.

<Begin Registration Form>

   Personal Info
   -------------

   Registered User Name:_____________________________________________

   Company:__________________________________________________________

   Street Address:___________________________________________________

   City:__________________________________ State:_____ Zip:__________

   Country:__________________________________________________________

   Phone:__________________________ Fax:_____________________________

   Email Address of Registered User:_________________________________

   Payment Method
   --------------

   [ ] Master Card  #______________________________

   [ ] Visa Card    #______________________________

   [ ] AMEX         #______________________________

   [ ] Discover     #______________________________

   Expiration Date:________________________________

   For security reasons, our credit card processing service requires:

   Name on Front of Credit Card:_____________________________________

   City/St and Zip of Card Holder:___________________________________


   License Size
   ------------

   [ ] 1-5  Users  $ 89.00             [ ] 26-50 Users        $189.00

   [ ] 6-25 Users  $129.00             [ ] 51-unlimited Users $249.00


   I want: ___ Win NT 3.51 Version   ___ Windows NT 4.0/Win 95 Version

   Administration Contact
   ----------------------

   Use this address to notify me of upgrades/fixes:

      EMAIL _______________________________

<End Registration Form>

