YOUR FULL NAME:
YOUR NRS-ONLINE IDENTITY:
REG ID:
I, the undersigned, whose full name is printed above, request that Sevik, Inc., the owner and
operator of the National Registration Service - Online (NRS-ONLINE.COM),
register the item accompanying this registration form.
Signature
Date
What is the Item ?
| [ ] Document or Book |
[ ] Photograph |
[ ] Compact Disk (CD-ROM) |
| [ ] Film Negative/Microfilm |
[ ] Computer Disk |
[ ] Computer Hard Drive |
| [ ] Other Computer Storage |
[ ] DVD |
[ ] VHS Cassette |
| [ ] Audio Cassette |
[ ] Other Audio Storage |
[ ] Other Video Storage |
[ ] Other:
|
Category for this Registration (optional):
Please mail registration form along with the item to:
Sevik, Inc.
Attn: NRS-ONLINE
PO Box 19762
Seattle, WA 98109
USA
- - - - - DO NOT WRITE BELOW THIS LINE - - - - - FOR NRS-ONLINE USE ONLY - - - - - -
RECEIPT STAMP:
RECEIVED BY:
[ ] Account verified (# )
[ ] Registry Updated [ ] Stored (#
)
NOTES: