LView Pro 1.D2 -- Individual User Registration Form
 
1. User information (please PRINT):
 
Name: ___________________________________________________________
Address line 1: _________________________________________________
Adreess line 2: _________________________________________________
City: ___________________ State: _____________ ZIP: _____________
Country (if other than USA): ____________________________________
Phone number: (___)______________ Date (MM/DD/YY): ____/____/____
Email address: __________________________________________________
 
2. Payment and fees:

Fees are in US dollars, please do not send cash. Checks and money 
orders must be made payable to MMedia Research. Select form of 
payment (check one):
 
__ Enclosed check or money order
__ Credit card payment: 
   ( )VISA ( )MasterCard ( )AMEX ( )Discover
   Name on card: _____________________________
   Card Number: ______________________________
   Expiration Date (MM/YY): ____/____
   Signature (required if form is faxed/mailed): _________________
 
3. Please select among the following options of delivery of LView 
   Pro 1.D2, or newer (CHECK ONLY ONE, add sales tax when necessary, 
   fill out the total amount):

( ) CD-ROM shipped to address WITHIN USA.................$40.00
( ) CD-ROM shipped to address OUTSIDE USA................$48.00
( ) 1.44 disk shipped to address WITHIN USA..............$35.00
( ) 1.44 disk shipped to address OUTSIDE USA.............$42.00
( ) email delivery...................................... $30.00

Florida residents please add appropriate sales tax...... $_____
Total:...................................................$_____
 
4. Mail this form together with payment to: 
 
   MMedia Research Corp
   LView Pro Registration
   1501 East Hallandale Beach Boulevard, #254
   Hallandale, FL 33009
   USA

*** When paying with a credit card, registration may be performed
    on-line at http://www.lview.com, or this form may be faxed to 
    954-458-9698 (Florida, USA) or emailed to register@lview.com