            The HelpDisque(tm) REGISTRATION/ORDER FORM

This is the shareware version of HelpDisque, and the base  
registration price is $49 US for a single user. If you want a 
printed manual with your order, please add $7.50;  Example: To 
register and order latest version is $49 inside USA or Canada.

( ) HelpDisque Registration for current ver ($49) ......______

( ) Order Printed Manual ($7.50) .......................______     

Shipping/handling for printed manual                   
( )                $10 USA and Canada, $20 foreign .....______

                                           ===================

                                              Total:    ______

 Name:             ____________________________________________

Address:          ____________________________________________

                  ____________________________________________

City, State, ZIP: ____________________________________________

Phone:            ____________________________________________

Internet Mail Address:   _____________________________________

Comments: ____________________________________________________ 

______________________________________________________________ 

______________________________________________________________ 

______________________________________________________________

Please send the completed form along with payment by check or 
money order (no PO's please) to:

Customized Service Systems, Inc. 

PO Box 99823 

Jeffersontown, KY  40269

PS: For foreign orders, please send a check drawn on a US Bank,  
US Postal or International Money Order, Travelers Checks, or  
cash, since the banks charge up to $60 collection fee for  
foreign checks, and $8 minimum for wire cash transfers.

PSS: Order before December 31, 1995 and receive the windows  
version absolutely free.

PSSS: Order before July 31, 1995 and become eligible for the  
Windows beta program.
