--------------- Diet Sleuth CHECK / MONEY-ORDER ORDER FORM --------------- I would like to register _______ copies of Diet Sleuth @ $34.99 apiece I would like to register _______ Diet Sleuth/Health Tracker Combos @ $39.99 apiece (Your registration code can be found in the registration email that was sent to you originally. The number must be included to be eligible for the discounted renewal price.) Maryland residents please add 6% sales tax. TOTAL AMOUNT ENCLOSED: _______________ in US funds. Please send my registration code to: Name: _________________________________________________________________ Address: ______________________________________________________________ City: ________________________________ State: _________________________ Zip or Postal Code: __________________ Country: _______________________ Email address: ________________________________________________________ Including your email address is VERY important as this is how we will contact you with your registration code. Make checks and money orders out to: Black Cat Systems Mail This Form To: Black Cat Systems 4708 Trail Court Westminster, MD 21158 USA -------------------------------------------------------------------------