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* Registration Form *
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<<You can also register online at www.codessesoft.com>>


1.  Print out this form.
2.  Fill in the information.
3.  Write a check (personal,cashiers, or money order) to Codesse Software for $34.95 USD.
4.  Mail this completed form and check to:

	Codesse Software
	37999 Upper Camp Creek Road
	Springfield, OR 97478

5.  You will be e-mailed a User ID number upon receiving your form and check.

(Please print clearly.)


Product:	GroceryIP v1.7


First Name: ______________________________________________________________

Last Name: ______________________________________________________________

Street Address: ___________________________________________________________

State: _________

Zip Code: __________

E-mail Address: ___________________________________________________________

Phone Number (Optional): _______________

Do you want GroceryIP on diskettes? (There is an added $11.00 USD S&H fee for diskette requests)

(YES)		(NO)

Comments:

_________________________________________________________________________

_________________________________________________________________________

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