              'Lectric Toolbox registration form 1.1
	     include one form for each copy registered

 Name:   ____________________________________________________

 Company:____________________________________________________

 Address:____________________________________________________

         ____________________________________________________

 City:   ________________________  St:______  Zip:___________

 Phone: (______)_________________    Country:________________

 
 

 Where did you get your copy of 'Lectric Toolbox?



 ____________________________________________________________

Send this form allong with $15.00 (U.S.) to:*

                    James Robinson
                    2809 Brookside Circle 
                    Paragould, AR 72450 
                    USA 

 

 All funds must be U.S.
 Make checks payable to James Robinson.
 Checks must be drawn on a US bank.

* If you are registering more than one copy you may include one 
  payment for the total amount of all registrations


          
           (Please allow 3 to 4 weeks for delivery) 
