Software Registration Form

Please send me the Site Key to register my copy of Visual MODFLOW.

To be completed by Waterloo Hydrogeologic, Inc.

To register your software license, please enter the Site key provided above in the License Control
window and then press the [Register] button. If you have any difficulties with the installation or
registration of your software license, please do not hesitate to contact a Waterloo Hydrogeologic
technical representative for assistance.

Please fax this completed Software Registration Form to Waterloo Hydrogeologic Inc. at
[phone].

User Information

Name:

Title:

Company:

Address:

City:

State/Province:

Zip/Postal Code:

Country:

Telephone #:

Fax #:

Email:

URL:

Software Licensing Information

Product Serial Number:

(sticker on back of installation CD-ROM)

Your Site Code:

(obtained from License Control window)

Installation Type:

(Stand-Alone or Network Server)

Selected Options:

(MT3D

99

, WinPEST, and/or 3D-Explorer)

Site Key: