AlarmPak Registration Form
----------------------------
If you like the program and wish to own a license to use it, please send us this registration form and your payment.  

Atomic Software
448 Bryce Street
Los Alamos, NM  87544

Your Name _______________________________

Address _________________________________

________________________________________

City ____________________________________

State ____    Zip  _____________  Country __________

Computer Preference:  [ ] Mac     [ ] Windows

e-mail Service ____________________________

e-mail address ____________________________

_________ Quantity of Licenses (one per Newton)
	
x  $15.00     Price per License ($15 US/each)

_________ Subtotal	

_________ New Mexico Gross Receipts Tax ($0.94/ea) - NM residents only.

_________ Total Enclosed	

I have read, understand, and agree with the ATMOIC SOFTWARE LICENSE AGREEMENT (signature is required):

Signature: ________________________________     Date: ___________
