

      Fax or Mail Registration Form                Date:
      ----------------------------------------------------------------
      Name of person or institution buying the license. (Used on
      reports as the test provider)  46 characters or less

 
      |______________________________________________________________|

      Registration level.  Level 1 = personal, Level 2 = Site License,
      Level 3 = Enterprise.  See license documentation for details.

      
      |_____|

      If you register for a level 2 license you must include the name
      of the site where this license will be used. 46 places or less.

     
      |______________________________________________________________|

                                                                              
      The following additional information will be needed:                    
                                                                              
      Name of contact:                                                        
                      |______________________________________________|        
      Address:                                                                
              |______________________________________________________|        
                                                                              
              |______________________________________________________|        
                                                                              
              |______________________________________________________|        
                                                                              
      Signature:                                 Date:
                |_______________________________|     |______________|

      See License information file for prices and details.  Purchase
      of the software implies submission to the license agreement.

      Phone:                                 License fee US$_________|
            |___________________________|
                                             Shipping    US$_________|
      Fax:  |___________________________|
                                             Total       US$_________|

      Level 1 = $25.00  2 = $225.00  3 = $425.00 (  Shipping = $5.00 )
                                                 (For 3 1/2" diskette)
      Make check or money       Scarecrow Logic  (    If necessary   )
      order in US $ only        P. O. Box 3624
      payable to:               San Rafael, CA 94912-3624

      or Fax this form to:  (415) 459-0375
      Visit the Y2Kare Web site for more details and support.
              Http://www.wco.com/~mvv/y2kare
      Feel free to email suggestions but no support questions please.
              mvv@wco.com


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