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                        WHDLoad Registration Form

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                Please fill out this form properly and
                send it together with your payment to:

                        Bert Jahn
                        Clara-Zetkin-Strasse 52
                        Zwickau
                        08058
                        GERMANY

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    EMail       
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    Name        
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    Street      
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    ZIP / Town  
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    Country     
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                                     _
    I want receive my keyfile via:  |_| email             30 USD / 20 EUR
                                     _
                                    |_| mail              35 USD / 25 EUR

    You may also send cash in your local currency, you have to calculate
    the amount yourself by using the actual exchange rate and adding 10%
    to cover bank currency conversion commission.

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      I have read the Licence and the Disclaimer and agree with them.


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             (Date)                             (Sign)
