AlarmPak* Registration Form

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If you like the program and wish to own a license to use it, please send us this registration form and your payment.  



Atomic Software

448 Bryce Street

Los Alamos, NM  87544



Your Name _______________________________



Address _________________________________



________________________________________



City ____________________________________



State ____    Zip  _____________  Country __________



Computer Preference:  [ ] Mac     [ ] Windows



e-mail Service ____________________________



e-mail address ____________________________



_________ Quantity of Licenses (one per Newton)

	

x  $15.00     Price per License ($15 US/each)



_________ Subtotal	



_________ New Mexico Gross Receipts Tax ($0.94/ea) - NM residents only.



_________ Total Enclosed	



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



Signature: ________________________________     Date: ___________