Registration Form for Dicom 4

Registration Form for Dicom 4.0

There is no registration fee for the free distribution version of Dicom 4.0,
but Knowbotron would like to know your opinion of the product.
Please complete the sections below and let us have your comments
about Dicom 4.0 and how it could be improved. The information you
supply below will not be made available to any third parties.

Name_________________________________________________


Company______________________________________________ 
Street_______________________________________________ 
Town/City____________________________________________ 
Post/Zip code________________________________________ 
Country______________________________________________ 
Telephone____________________________________________ 
E-mail_______________________________________________ 
Platform: Windows95/Windows98/WindowsNT 
Type of use: Private/Professional/Corporate/Site 
Industry sector______________________________________ 
Where obtained?______________________________________ 
Comments_____________________________________________ 
_____________________________________________________ 
_____________________________________________________ 
_____________________________________________________ 
_____________________________________________________

Postal address:

Knowbotron
Debasish C Saha
110, Sher-Shah-Suri Road
Mohammadpur
Dhaka-1207, Bangladesh
E-mail: support@knowbotron.com

An interactive version of this form is available at the web site:
http://www.knowbotron.com/