NotePakŠ Registration Form
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If you like the program and wish to own a license to use it, please send us the NotePak Registration form and your payment.  You can also register in CompuServe's Go SWREG area.  Look for ID: 2279 (Mac) or 2297 (Windows)

Atomic Software
448 Bryce Street
Los Alamos, NM  87544

Your Name _______________________________

Company Name ____________________________

Address _________________________________

________________________________________

City ____________________________________

State ____    Zip  _____________  Country __________

Computer Preference:  [ ] Mac     [ ] Windows

e-mail Service ____________________________

e-mail Address ____________________________

Phone Number _____________________________

_________ Quantity of Licenses (one per Newton)
	
x  $49.00     Price per License ($49 US/each)

_________ Subtotal	

_________ New Mexico Gross Receipts Tax ($2.41/ea) - NM residents only.

_________ Total Enclosed	

I have read, understand, and agree with the NOTEPAKŠ SOFTWARE LICENSE agreement (signature is required):

Signature: ________________________________     Date: ___________