+-----[ GRUNT! v1.040 (c)1996.]-----------------------------------------------+
|                                                                             |
|                    "GRUNT!" - REGISTRATION AND ORDER FORM                   |
|                                                                             |
| Your full legal name: _____________________________________________________ |
|       (please print)       Last           First           MI                |
|                                                                             |
| Your mailing address: _____________________________________________________ |
|                                                                             |
|     Home Phone:(___) ___-____     _________________________________________ |
|                                    City            State           Zip-Code |
| Business Phone:(___) ___-____                                               |
|                                                                             |
| Internet Address: ________________________________________________________  |
|                                                                             |
| BBS Name: _____________________________________ Phone:(___) ___-____        |
|                                                                             |
| BBS Software: _____________________ Nodes: ____ Network: __________________ |
|                                                                             |
+-----------------------------------------------------------------------------+
|                                                                             |
|   Qty Product                                                Cost           |
|   === ===================================================== =======         |
|   ___ GRUNT! Registration Activation Key .................. $ 20.00         |
|   --- ----------------------------------------------------- -------         |
|                                                      Total: $______         |
|                                                                             |
|  1. Make your check/money order payable to "MICHAEL HOENIE".                |
|  2. Please! - United States Currency Only!                                  |
|  3. Mail your registration key and payment to:                              |
|                                                                             |
|                     POST OFFICE BOX 58401                                   |
|                     SALT LAKE CITY, UTAH  84158-0401, (USA)                 |
|                                                                             |
+-----------------------------------------------------------------------------+
|                                                                             |
| NOTICE: This area MUST be filled out in DETAIL. The registration KEY that   |
|         you will receive will contain your name, your BBS name, and your    |
|         ID KEY code that you will punch in to GRUNTCFG. Whatever you put    |
|         here will be hard coded into your registration key!                 |
|                                                                             |
|           NOTE: DO NOT USE MORE SPACES THAN THOSE ALLOWED BELOW.            |
|                 YOU MUST USE YOUR REAL NAME AND FULL BBS NAME.              |
|                 PLEASE PRINT LEGIBLY.                                       |
|                                                                             |
| YOUR NAME: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _      |
|                                                                             |
|  BBS NAME: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _      |
|                                                                             |
|  YES NO!                                                                    |
|  [ ] [ ] Send my registration via. Internet (enter account above).          |
|  [ ] [ ] Place me on the GRUNT! Internet Mailing List.                      |
|                                                                             |
+-----------------------------------------------------------------------------+