
FMBoss Individual User Registration Form


First Name: __________________________________

Last Name : __________________________________


Street: _______________________________________

City  : _______________________________________

State : _______________________________________

Zip   : _______________


(IMPORTANT)
E-Mail address: _____________________ 


Please indicate which Version of FMBoss you would like and number 
of copies.  Fees are in US dollars, preferred payment is Money 
Order, Check, or Cash.  


Windows 95: _____  x   Copies _____  x $15.00  = $__________ 

Windows NT: _____  x   Copies _____  x $15.00  = $__________ 


Delivery Method: (Check One)

E-Mail        ______  (Shipping - N/A)          = $   N/A 

Regular Mail  ______  $5.00 x Copies ______     = $__________


                                           TOTAL= $ _________


Send this "completed" form to:

 Jeff Lawrence 
 Att: FMBoss Registration
 7075 Sycamore Ct. NE
 Keizer, Oregon 97303


