        To:  Oliver Fromme                                      [16c]
             Leibnizstr. 18-61
             38678 Clausthal
             GERMANY


        Single user registration form for QPV/386, valid for all future
        versions.  Please print this file and send it to the address
        above.  Please write clear and legible!  Please read the
        REGISTER.DOC file first!  Germans please use the German
        registration form instead of this one.

        Your name:  ________________________________________

        Address:    ________________________________________

                    ________________________________________

                    ________________________________________

        Country:    ________________________________________

        Email address
        (optional): ________________________________________

        Please tick (see REGISTER.DOC for help, e.g. other currencies):

        []  QPV/386 single private registration:       30 DM or  20 $US
        []  QPV/386 single commercial registration:    60 DM or  40 $US

        []  QPV/386 current shareware (no reg.!):       5 DM or   5 $US
        []  QPV/386 sharew.+images on MO disk 128 Mb:  98 DM or  75 $US
        []  QPV/386 sharew.+images on DC2120 (QIC80):  88 DM or  65 $US

        []  JPEG Unit / source, private:               80 DM or  60 $US
        []  JPEG Unit / source, single commercial:    300 DM or 220 $US
        []  JPEG Unit / source, unlimited commerc.:  1200 DM or 900 $US

        []  foreign cheque surcharge:                  15 DM     10 $US
                                                   --------------------
                                             Sum:  ____________________

        Payment:  []  cash (enclosed), $US or DM  (see PRICES.DOC)
                  []  Eurocheque (enclosed), DM only
                  []  other cheque (enclosed), add 15 DM or 10 $US


        Signature: ___________________________________________________
