		Phone Dialer Pro ver.3.7 Registration Form  
			Product No.
		-------------------------------------------

Name:__________________________________________________________

Address:_______________________________________________________

	_______________________________________________________

City_______________________________State:________Zip:__________

Phone:(optional)_______________________________________________

Where did you obtain this software from?_______________________

E-Mail Address:_________________________________________________   
    
Do you wish delivery of the Registration Key by e-mail? Yes__ No__

If you need the Registration Key sent to you on disk, then you must
include the proper postage.

*The cost of the Licence/Registration Key is $19.95.

	Qty.                    		 Amount  
	--------------------------------------------------------
	______ Reg Key		 		 @ 19.95 ea.	________
	
		   	Site Licensing/per App.
		   	-----------------------
	______ 2 to 5 Sites  			 @ 14.95 ea. 	________
	______ 6 to 9 Sites 			 @ 12.95 ea. 	________
	______ 10 to 29 Sites 			 @ 10.95 ea. 	________
	______ 30 to 99 Sites 			 @  8.95 ea. 	________
	______ over 100 Sites 			 @  6.95 ea. 	________
	Sending:- By e-mail  			 Free		
	Sending:- By post (Canada and the U.S.)	 @  2.95 ea.	________
	Sending:- By post (Foreign)		 @  4.95 ea.   	________                                 
			
			                 TOTAL  ------------>	________

Forms of Payment:
=================  

Pay online:
-----------

https://www.regnow.com/softsell/nph-softsell.cgi?item=3853-1

and e-mail this form to: jkozl@altavista.net


By mail:
--------

Money/Postal Order or Certified Cheque  

Mail payment with this form to:
		
		Jacek Kozlowski 
		32 Larstone Ave.,
		Toronto, ON M8Z 2N8
		Canada

E-mail:  jkozl@altavista.net
		