NRS-ONLINE REGISTRATIONS FORMS : POSTAL REGISTRATION FORM (1/1)

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: