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/* Registration Form for AwBmReader 1.74 */
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Please fill this form out and send it to:

e-mail: [e-mail]
with Subject: Registration for AwBmReader 1.74 (Phoenix)

REGISTRATION IS FREE!

If you like this program you may also send me a postcard:

392024, Russian Federation, Tambov,
Ryleev's Street, Building 73, Apartment 160
Anthony Borisow :)

Only complete forms will be accepted!
Registered version of software will be
emailed to you ASAP. Good luck.

Those fields marked with '*' are compulsory

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Address: (No P.O. box !) ...................................

*Last name: ...................................................
*First name: ...................................................

*Company: ...................................................

Street: ...................................................

*Country: ...................................................
State: ...................................................

Zipcode: ..................
City: ...........................................................

*E-Mail: ...................................................

*Date, Signature ...........................................

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