Please send this registration form, along with the registration
fee (U.S. funds please), to:

Robert J. Wilt
542 Erickson Rd.
Ashby, MA 01431 USA

The registration fee is $35 for new users, $10 for registered users
of GlazeChem 1.2. After your registration is received and processed,
you will be emailed a registration code. Codes are usually delivered
within a week.

______ New User ($35)            ______ Registered GlazeChem 1.2 User ($10)




Your Name:


Mailing Address:


Email address:


Today's Date:

Version of GlazeChem: 2.12

Your computer:
  Processor (i.e. '486, Pentium):
  Speed (i.e. 266 MHz):
  RAM (i.e. 32Mb, 64 Mb):
  Hard drive size (total):
  Version of Windows (95/98/NT/2000/ME):
  Video mode: (check your video driver software or the Windows control panel if unsure)
      # of colors (16, 256, 64K, 24-bit):
      Resolution (640x480, 800x600, 1024x768, 1280x1024):

  Anything else interesting about your computer:

How did you learn about GlazeChem?


Comments, requests, etc.: (please feel free to send or email more comments after you've
used the program for a while)


