

                            HelpPC Registration Form


        Name:           ____________________________________________

        Address:        ____________________________________________

                        ____________________________________________

        City/State:     ____________________________________________

        Country:        ______________________   Zip: ______________

        Telephone:      (________)  _________ - ____________________


        Diskette preference (circle one):           5.25         3.5

                Number of copies       Price per copy

                       1             $25 per diskette
                      2-5            $20 per diskette
                       6+            $15 per diskette
                                     $5 per upgrade (any version)

        Number of individual copies   _________   at  $ ________ ea.

        Total enclosed                        $ ____________________


        Where did you first learn about HelpPC?   __________________

        Where did you get your copy of HelpPC?    __________________

        Do you use CompuServe/Genie/BIX/Prodigy?  __________________

        What brand of machine are you using:      __________________

        CPU type (circle one):     8088    8086    286    386    486

        How fast, how much memory & disk:   ________________________

        Video type (circle one):     MDA    CGA    HGC    EGA    VGA

        What would you like to see added/changed in HelpPC?  (Please
        attach any additional comments/suggestions to this form.)








        Mail completed form and check or money order to:

                       Dave Jurgens
                       1550 Alton Darby Creek Road
                       Columbus, Ohio 43228
