LView Pro 1.B -- Site Registration Form

1. Site information:

Site Name: ______________________________________________________
Site Address:____________________________________________________
City: ___________________ State: _______________ ZIP: ___________
Country (if other than US): _____________________________________
Phone number: (___)______________ Date (MM/DD/YY): ____/____/____
Authorized representative: ______________________________________
E-mail address (optional):_______________________________________

2. Choice of registered version(s) (check all that apply,
   up to the total number of copies being registered):

__ 386         Windows 3.1, 16-bit application
__ 386         Windows 3.1+Win32s/Windows NT, 32-bit application
__ 486/Pentium Windows 3.1, 16-bit application
__ 486/Pentium Windows 3.1+Win32s/Windows NT, 32-bit application

3. Shipping and Handling (check one):

__ E-mail uuencoded file to: ____________________________________
__ 3.5'' DS/HD disks (Shipping and Handling: US: $5.00 per 
                      disk *, Non U.S.: $12.00 per disk *)

* Each version checked in item (2) requires one separate disk.

4. Payment and fees:

Fees are in U.S. dollars, please do not send cash. Checks and
money orders must be made payable to MMedia Research.
Select form of payment (check one):

__ Enclosed check or money order in U.S. dollars
__ Credit card payment: ___ VISA   ___ MasterCard    
   Card Number: ______________________________
   Expiration Date (MM/YY): ____/____
   Cardmember signature (required): ______________________________

5. Pricing for the use of LView Pro 1.B or newer, per site 
   computer (Write for pricing on quantities over 99 computers):

__  1st computer at $30: ............................. = $ 30.00
__  2nd to 24th computer at $20 each: ...... ____ x 20 = $______
__ 25th to 99th computer at $17 each: ...... ____ x 17 = $______
__ Total U.S. Shipping and handling (if not E-mail)..... $______
__ Total Non U.S. Shipping and handling (if not E-mail). $______
__ Florida companies add appropriate sales tax.......... $______
Total:.................................................. $______

6. Mail this form together with payment to:

	MMedia Research
   Attn: Leonardo Haddad Loureiro
   1501 East Hallandale Beach Boulevard, #254
   Hallandale, FL 33009
   USA

   Or: If credit card payment was selected, this form may be faxed to 
   954-458-9698 (Florida, U.S.A.) or E-mailed to mmedia@world.std.com.