			REGISTRATION FORM

			PIAF, INC.
			3918 ORCHARD COURT
			BOULDER, CO 80304-1023
			(303) 786-8222

1) Circle a Registration Option:

OPTION 1 - $69 (plus $6 s&h)
    Registered Surefire VS1.0 disks plus 6 months technical support,
    460 page guide, demonstration and practice documents.

OPTION 2 - $29 (plus $4 s&h)
    Registered Surefire VS1.0 disks plus 2 technical support calls
    and demonstration Smart Documents.

OPTION 3 - FREE
    1 Surefire technical support call plus new product notification. 

2) Circle Disk Size:	5 1/4"		3 1/2"

3) Check here [] to register Surefire Contacts	$19 (plus $4 s&h)
   Note: If you have not already registered SUREFIRE you must choose
   option 1 or 2 above along with this one. 

	TOTAL AMOUNT ENCLOSED:  $____________ (Colo res. add 3% tax)

VISA or MC #:________________________________________

EXPIRATION DATE:______/_______ SIGNATURE___________________________

Please make checks payable to : PIAF, INC.  (U.S. funds only)

4) Fill out below:

NAME____________________________ TITLE_______________ DATE__________

COMPANY_______________________________________  PHONE_______________

ADDRESS_____________________________________________________________

CITY____________________________________ STATE_______ ZIP___________

5) Please answer these questions:

    1. What industry do you work in? _________________________________

    2. What is your job function? ____________________________________

    3. Will you use Surefire at home or work? ________________________

    4. What do you like MOST about Surefire/Surefire Contacts? _______
    __________________________________________________________________

    5. What do you like LEAST about Surefire/Surefire Contacts? ______
    __________________________________________________________________

    6. Other Comments (use back for more room)
    __________________________________________________________________
    __________________________________________________________________
