REGISTRATION FORM
=================

YOU MUST REGISTER NOW TO RECEIVE TECHNICAL SUPPORT 
AND UPGRADE INFORMATION.

For more information on how to fill out this form, see the leaflet
"Registration Instructions".  A printed version of this form is
available in the registration materials packet.
 



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1.  Instructions
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Fill out this form using your editor, and send it to Wolfram Research
by any of the following methods:

*  Fax this form: 217-398-0747 

*  Mail: Use the Business Reply Mail envelope that came with your
   registration packet to mail this form to 
   User Services, Wolfram Research, Inc., 100 Trade Center Drive, 
   Champaign, Illinois, 61820-7237 USA.

*  Electronic mail: Send this form by electronic mail to register@wri.com.


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2.  Registration contact
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(The registration contact is the person to whom information on
licensing, upgrades, etc. should be sent.)
 
Mathematica license number (found on your License Certificate):

Name: 

Organization: 

Department: 

Street address: 

City: 

State: 

Zip/Postal code: 

Country: 

Telephone: 

Fax: 

Electronic mail address: 




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3.  Technical support contact
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Is the individual named above the support contact for this copy of
Mathematica?  (Insert an x in the appropriate brackets.) 
[ ] Yes
[ ] No

 
If not, give the support contact's name here.

Support contact (who will be eligible for technical support): 




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4.  Your field and specialty
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[ ] Administration
[ ] Arts/Humanities
[ ] Business/Finance
[ ] Computer sciences  
[ ] Engineering
[ ] Life sciences
[ ] Mathematical sciences
[ ] Physical sciences
[ ] Social sciences
[ ] Other:
 
Specialty: 



 
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5.  Your occupation
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[ ] Computer professional
[ ] Computer support group member
[ ] Engineer
[ ] Financial analyst
[ ] Professor
[ ] Researcher/Staff scientist
[ ] Graduate student
[ ] College student
[ ] Pre-college student
[ ] Other: 
 
 
 
 
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6.  Introduction to Mathematica
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How did you find out about Mathematica?
[ ] Advertisement
[ ] Catalog
[ ] Colleague/Friend
[ ] Dealer
[ ] Educational setting
[ ] Electronic bulletin board
[ ] The Mathematica Book
[ ] Press: general 
[ ] Press: technical
[ ] Other: 
 
 
 
 
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7.  System configuration
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Which of the following does your computer system have?
[ ] CD-ROM
[ ] 1/4" tape
[ ] 5 1/4" diskettes
[ ] 3 1/2" diskettes
[ ] Sound
[ ] Modem
[ ] PostScript printer
[ ] Non-PostScript printer, type: