   ==================================================================
              WebExplorer Organizer V1.x registration form         
      WebExplorer Organizer is Copyright (c) 1996 by ONG SoftWare.  
                          All Rights Reserved.                         
   ==================================================================

   Note: Each registration of WebExplorer Organizer comes with only
	 one license for WebExplorer Organizer.

   Note: Multiple copies require one user name for every copy ordered.

	          Mail Orders To: BMT Micro
        	                  PO Box 15016
                	          Wilmington, NC  28408
                        	  U.S.A.
	
        	    Voice Orders: 8:00am - 7:00pm EST (-5 GMT)
                	          (800) 414-4268 (Orders only)
                        	  (910) 791-7052 (Orders / Order Inquires)

	              Fax Orders: (910) 350-2937 24 hours, 7 days a week
        	                  (800) 346-1OS2 24 hours, 7 days a week

	   Online Orders via BBS: (910) 350-8061 10 lines, all 14.4K
        	                  (910) 799-0923 28.8k v.FC

	          via Compuserve: 74031,307
        	    via Internet: bmt@wilmington.net
	             via AOL    : bmtmicro

	We accept Visa, Mastercard, Discover, American Express, Diner's Club,
	money order, cashiers checks, and personal checks.  We also accept
	DM and British currency via registered mail.

	Personal checks are subject to clearance.


        Name: ____________________________________________________________

     Company: ____________________________________________________________

     Address: ____________________________________________________________

              ____________________________________________________________

        City: _______________________   State/Province: __________________

     Country: ____________________________ Postal Code: __________________

       Phone: ____________________________________________________________

         Fax: ____________________________________________________________

       Email: ____________________________________________________________


     Product                           Price        Quantity   Total
     --------------------------------------------------------------------
                  ( Funds below specified in US dollars )

     _WebExplorer Organizer V1.x_____  $_15.00__ x  ________ =  $____.___

                                                     Subtotal:  $____.___

            North Carolina residents, please add 6% sales tax: +$____.___

                                			Total:  $____.___


     Shipping (check one):

               ___ Email
               ___ 1st Class Mail

    For credit card payment only:

      Circle one: VISA / Master / Discover / AMEX / Diner's Club

      Credit card number: _____________________________________________

         Expiration date: ___/___

 Authorization signature: _____________________________________________
