
                  PM System  REGISTRATION AND ORDER FORM     






    Facility/Company Registration Name

               ____________________________________________

    Name(s)    ____________________________________________

    Address    ____________________________________________

    City       ____________________________________________

    State      _____________      Zip   _____________

    Phone:     (______)________________  Fax  (______)________________


            Check disk size desired

           [  ]   3.5 INCH DISK        
           [  ]   5 1/4 INCH DISK         
                                                     $99.00 EA


    Consideration will be given to lower registration fees depending on 
    limited use, non-profit organiations, churches or other explanation.  
    Include written description and check for prompt processing.  Check 
    will be returned if offer not accepted.


                                    Total Enclosed:  $ _________

               



Signed:    ____________________________________________
           Applicant(s)

           ____________________________________________


                      
           Make checks payable to       Frank M. Murray    
          
           Send to:       Murray Enterprise
                          1101 Seafarer Circle #305
                          Jupiter, Fl. 33477-9066


           PM System COPYR. 1993 FRANK MURRAY ALL RIGHTS RESERVED


