GusDelay v1.0 Registration Order Form
                    (see REGISTER.TXT for instructions)
 
                       Information given here will NOT 
                        be given to any mailing lists

                             Please print legibly


                    Name: _________________________________________

               Address 1:__________________________________________

               Address 2:__________________________________________

               Address 3:__________________________________________

                    City: _________________________________________

State/Province/Territory: _________________________________________
         
         Zip/Postal Code: _________________________________________
          
          E-mail Address: _________________________________________

 Number of registrations: _____ * US$10 = US$ _____ total enclosed


Send to:   David MacMahon
           22 Lake Street
           Waltham  MA  02154-3116
           USA