        To:  Oliver Fromme         after 30-September-1996:     [15e]
             Leibnizstr. 18-61        Klingestr. 2
             38678 Clausthal          38640 Goslar
             GERMANY                  GERMANY


        Single user registration form for QPEG386, valid for all future
        versions.  Please print this file and send it to the address
        above.  Please write clear and legible!  Please read the
        REGISTER.DOC file first!  Germans please use the German
        registration form instead of this one.

        Your name:  ________________________________________

        Address:    ________________________________________

                    ________________________________________

                    ________________________________________

        Country:    ________________________________________

        Email address
        (optional): ________________________________________

        Please tick (see REGISTER.DOC for help, e.g. other currencies):

        []  QPEG386 single private registration:       30 DM or  20 $US
        []  QPEG386 single commercial registration:    60 DM or  40 $US

        []  QPEG386 current shareware (no reg.!):       5 DM or   5 $US
        []  QPEG386 sharew.+images on MO disk 128 Mb:  98 DM or  75 $US
        []  QPEG386 sharew.+images on DC2120 (QIC80):  88 DM or  65 $US

        []  JPEG Unit / source, private:               80 DM or  60 $US
        []  JPEG Unit / source, single commercial:    300 DM or 220 $US
        []  JPEG Unit / source, unlimited commerc.:  1200 DM or 900 $US

        []  foreign cheque surcharge:                  15 DM     10 $US
                                                   --------------------
                                             Sum:  ____________________

        Payment:  []  cash (enclosed), $US or DM
                  []  Eurocheque (enclosed), DM only
                  []  other cheque (enclosed), add 15 DM or 10 $US


        Signature: ___________________________________________________
