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    EMU386 Registration Form                       Version 1.34;beta 1
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				    Order date: ______________, ______

    Name: ____________________________________________________________

    Organization (optional): _________________________________________

    Address: _________________________________________________________

    __________________________________________________________________

    City: _______________________________ ZIP/Postal code: ___________

    State/Province, Country: _________________________________________

    I got shareware version from: ____________________________________

    If newer version may complete within weeks:

    [ ] Yes I will wait for ______ weeks, beyond that send me current
	version. Notify projected delivery date.
    [ ] I will not wait, send me current version.

    Method of delivery:
    [ ] via e-mail, recommended ............................(free S&H)

	e-mail address: ______________________________________________
	Format:     [ ] MIME-encoding       [ ] UU-encoding

    [ ] On disk via postal mail ...................... (add US $5 S&H)
	Disk type:  [ ] 3.5" 720 Kb         [ ] 5.25" 360 Kb
		    [ ] 3.5" 1.44 Mb        [ ] 5.25" 1.2 Mb

    Registration license fee:
    [ ] EMU386 shareware version .................. (free, except S&H)
    [ ] EMU386 personal use license ..................... (US $10) (*)

						       ---------------

					  Total US $:  _______________
    Payment method:
    [ ] US $ cash, enclosed.
    [ ] International postal money order, US $ only.
    [ ] Bank transfer (**)

    (*)   Single user license,  a non-exclusive license to use  EMU386
	  on  one  standalone computer at one time. For any  cases  of
	  commercial  licenses contact the author for special discount
	  rates and arrangements.
    (**)  Contact the author first for details.

    Please also answer the following questions concerning your system.
    It helps me if problems occur.

    CPU Type, brand: _________________________________________________

    Memory, amount and type: _________________________________________

    Extention cards: _________________________________________________

    Comments, bug reports, wishes: ___________________________________

    __________________________________________________________________

    __________________________________________________________________



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