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                        WHDLoad Registration Form

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                Please fill out this form properly and
                send it together with your payment to:

                        Bert Jahn
                        Franz Liszt Strasse 16
                        Rudolstadt
                        07407
                        GERMANY

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    EMail
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    Name
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    Street
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    Town
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    Country
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                                       _
    I want receive my keyfile via:    |_| email         20 US$ / 30 DM
                                       _
                                      |_| mail          23 US$ / 35 DM

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      I have read the Licence and the Disclaimer and agree with them.


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