_________________________________________ (Company)

    _________________________________________ (Name, Department)

    _________________________________________ (Address)

    _________________________________________ (Phone, Fax, email)

    _________________________________________ (State, Country)


    Fax +49 (821) 514831


    AIT GmbH
    Alte Gasse 12

    86152 Augsburg
    - Germany -


    R E G I S T R A T I O N

    I herewith order:

    ___ licence(s) of The Heap Debugger V2.0:

        For each ordered licence I obtain a floppy disk (3,5") with
        the full version of the Heap Debugger.

        Prices:

        1      Copy .................... DM   85,--
        2 -  4 Copies .................. DM   70,-- each
        5 -  9 Copies .................. DM   50,-- each
        >=  10 Copies .................. DM   40,-- each


        For shipping add              +  DM   10,--


        So the total amount is           DM ____________
        DM (= German Marks) are
        accepted only

    Payment by [ ] Mastercard or [ ] Eurocard:


    Credit Card # __________________________________________


    Expiration Date ____________  Signature ________________


    Date of Signature ________________