
WinCtrl -- Individual Registration Form

 
1. User information (please PRINT):
 
Name: ___________________________________________________________
Address: ________________________________________________________
City: ___________________ State: _____________ ZIP: _____________
Country: ________________________________________________________
Phone number: (___)______________ Date (MM/DD/YY): ____/____/____
Email address: __________________________________________________

 
2. Shipping and Handling (check one):
 
__ Email registration key to email address in (1) above.
__ Mail 3.5'' DS/HD disk to mailing address in (1) above.
 
 
3. Check all that apply and fill in the blanks:

__ Users IN Croatia:
__ One registered copy of WinCtrl ........................   30Kn
__ Shipping and Handling .................................   10Kn
Total:.................................................... ____Kn

__ Users OUTSIDE Croatia:
__ One registered copy of WinCtrl ...........................$ 10
__ Shipping and Handling ....................................$  5
Total:.......................................................$___


4. How did you get WinCtrl?

__ Downloaded from: _____________________________________________
__ Friend gave me
__ I found it on shareware CD-ROM: ______________________________
__ Other: _______________________________________________________


5. Mail this form together with payment to: 
 
   Eden Kirin
   Remetinecka 151
   10000 Zagreb
   Croatia, Europe


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Thank you for registering WinCtrl!

