Imagery v1.0 Registration Form


Mail this form to:

Ursus Computing Pty. Ltd.
PO BOX 116
Adelaide 5000
South Australia 
Australia

Please Include a cheque/money order for US $50.00 (or AUS $65.00) for  
the development version, or US $10.00 (or AUS $15.00) for the end-user
version. The Cheque should be made out to Ursus Computing Pty. Ltd.

Full Name: __________________________________________________________

Company Name: _______________________________________________________

Development version only.
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Development Environment: ____________________________________________

Development/Target Hardware configuartion:
_____________________________________________________________________
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E-Mail Address: _____________________________________________________

Full Postal Address:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

How did you discover/get Imagery:
_____________________________________________________________________

Recommendations for future versions:
_____________________________________________________________________
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Method of delivery: _________________________________________________

Quantity and Version:  
(put the quantity in the brackets)

	Development (US $50) [  ]
	End user    (US $10) [  ]