Registration Form


Name: ____________________________________________________________

Street: ___________________________________________________________

City: ______________________ State: ______ Zip code: ___________________

Country: __________________________________________________________

Phone: ___________________________________________________________

Program registering: ________________________________________________

Computer: ________________________________________________________

On-line service or BBS's: ____________________________________________

________________________________________________________________

Where did you get the program: ________________________________________

________________________________________________________________

Amount enclosed: __________________________________________________
* Add $1.00 shipping to Canada and Mexico. Add $3.00 shipping to 
  anywhere outside of North America.

Send to:
                
                Burnham Park Software, Inc.
                P.O. Box #814
                Chicago, IL 60690-0814