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                    ThunderByte AntiVirus Professional
                 SINGLE (PRIVATE) USER REGISTRATION FORM

ThunderByte Australia                           Tel: +61 (0)7 3204 5000
PO Box 29  Kallangur
Australia 4503                                  BBS: +61 (0)7 3886 1886


Name: ____________________________________________  Date: ___ /___ /___

Street Address: _______________________________________________________

City: _____________________________  State: ___________________________

Country: __________________________  ZIP/Post Code: ___________________

Phone: ____________________________  Fax: _____________________________


OPERATING SYSTEMS:   [ ] DOS+Windows3.xx   [ ] Windows95


LICENSE and SOFTWARE:   $159.00 (including p&p)  (Australian Dollars!)


METHOD OF PAYMENT:
[ ] Bank Transfer to:  ANZ Bank - Kallangur   (Branch 014244)
                       Account Name   : ThunderByte Australia
                       Account Number : 2596 81503


[ ] Cheque   [ ] Money Order   [ ] Bankcard   [ ] Mastercard   [ ] Visa


Credit Card Number ______-______-______-______   Expiry Date ____ /____

Card Holder's Signature ______________________

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