NetLink Remote Registration
Version 1.0.3
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Fill out this form completly and mail to the following address. Make checks payable to Joe Kloss
I promise not to sell my name list to any orgnaization. ( I hate junk mail too. )

Joe Kloss
13700 Alton Parkway, Suite 154
Irvine, California 92718

NetLinkR@AOL.com
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Fill the Name and Organization fields and check the one that NetLink Remote is to be registered to.

__ Name: 

__ Organization:  
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Check if you would like the reply to be sent by paper mail and/or need a reciept. ( add $1 to the total if checked )
Your address is only required if you have requested a reply by paper mail.

__ Send Reply by Paper Mail

Street Address: 

City: 

State: 

Zip: 

Country: 
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An E-mail address is optional if you have requested paper mail, otherwise it is required.

E-mail Address: 

Check if you would like to recieve updates and news by E-mail.

__ Send Me E-mail Updates
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Enter the number of requested licenses and the amount inclosed.
1 = $10 US, 2 = $15 US, additional licences are $7.50 US eash.
Note: 2 registered copies are required to avoid the 10 minute time limit.

Number of Licenses: 

Amount Enclosed: 
