ZDIFF 2.3 REGISTRATION FORM

                          Date :  ______/______/______


    TO:

               Christophe Dubourg
               23, rue Victor Hugo
               78370 PLAISIR
               FRANCE

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    FROM:

               Name: _______________________________________________

      Compuserve Id: _______________________________________________

     e-mail address: _______________________________________________

  [Company / Title]: _______________________________________________

            Address: _______________________________________________

                     _______________________________________________

              State: ______________________ Zip Code: ______________

            Country: ______________________ Phone: _________________



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    Please check the appropriate box(es), and fill the fields below:


    [ ]  ZDiff on 1 computer ............................  = $____20


    [ ]  ZDiff DPMI on 1 computer .......................  = $____40


    [ ]  ZDiff DPMI on 2 to 4  computers .... $25 X _____  = $______


    [ ]  Site licence (*) ...............................  = $___100

    (*) Site licence includes DOS and DPMI versions of ZDiff for
        unlimited users.

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    [ ]  Payment by check, (bank fees) please add .......... $____40

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                                                    TOTAL  = $______


     PLEASE INCLUDE THIS FORM WITH YOUR *CASH* OR INTERNATIONAL
           POSTAL MONEY ORDER (or CHECK if you added $40).