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InterAx Registration Form

Name:

Organization/ Company Name:

Address:

City, State & Zip Code:

Full E-Mail Address:
(Your unlock code will be e-mailed to you)

License Type (Circle one):     Personal License - $60 Sale: $20       Site License- $150 Sale: $100
 

Optional Questions:

Age:

Sex (circle one): Male / Female

Do you own... (circle all that apply): Digital Camera  /  Motion Video Capture Device  / Scanner 
                                                   3D Rendering Software

How did you hear about InterAx?:

Cognitial Software
3431 Randolph St
Lansing, IL  60438-2313

©2002-2006 Cognitial Software