WINCOIN REGISTRATION FORM

Please print and return this form with your payment by check
for the amount indicated below to:

    Bob Stech
    35151 Glen Kyle Lane
    Willoughby Hills, Ohio 44094


Registration Fees
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[ ] WINCOIN v3.5                               $29.00
    Register me for Wincoin and send me
    my registration code and the latest
    version.

    Wincoin is shipped on 3 1/2" disk format

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[ ] If I currently have the latest version,
    send my registration information now and
    send me the next version when it is available.
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Name ________________________________________________

Address _____________________________________________

City ___________________ State ________Zip___________


    Where did you get your copy of WINCOIN?

    ______________________________________


Suggestions/Comments:

_________________________________________________________

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Thank you for supporting the Shareware concept!
