---[NUKE - Secure File/Disk Deletion Utility - Version 3.1]----------------
[*Registration Form*]------------------------------------------------------
NOTICE: PLEASE TYPE OR PRINT IN THE INFORMATION, ORDERS CANNOT BE
PROCESSED IF THE INFORMATION CANNOT BE READ.

Name:    [________________________________]
Address: [________________________________]
Address: [________________________________]
City:    [________________]
State:   [___]
Zip Code:[________________]
Country: [________________]
Phone  : [________________] = Area Code First!
InterNet:[_________________________________________________]
FidoNet.:[_________________________________________________]
Computer System: [________________________________]

Please answer the following questions:

Disk Size and Type:
[_] 3.5 High Density   [_] 5.25 High Density
[_] 3.5 Low  Density   [_] 5.25 Low  Density

Please select method of Payment:

[_] Cashiers Check
[_] Certified Check
[_] Postal Money Order

No other forms of payment are accepted. Checks must be for $10.00 and
$10.00 only! Invalid checks are destroyed and nothing will be sent.

Please print out this form and mail (along with your check for $10.00)
to:

Dustin Cook
Po Box 154
New Gloucester, Maine
04260-0154

Please give atleast 2 weeks for delivery. Not responsible for lost mail.
All valid orders are shipped withen 2 business days of recieving
payment.

Thank you for registering. It is certainly appreciated!

Suggestions, comments, bug reports, problems, or anything else:


