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|                      -*-  SFQ Registration Form -*-                        |
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|                                                                            |
|  Send to:  Eldon Martin                       The Data Sector BBS          |
|            HCR 75 Box 99                      (717) 485 - 5914             |
|            McConnellsburg, PA  17233          SFNET Node A0717008          |
|                                                                            |
|  Registration fee is $10  (PA residents add 6% sales tax)                  |
|  Foreign orders use international money order payable in U.S. funds        |
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|                                                                            |
| Name___________________________________________________                    |
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| Street Address_________________________________________                    |
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| City___________________________ State_____ ZIP_________                    |
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| BBS Name_______________________________________________                    |
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| BBS Phone Number_______________________________________                    |
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| BBS Software___________________________________________                    |
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|                                                                            |
| [ ] Send the registered version by U.S. Mail                               |
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| [ ] I'll download the registered version from The Data Sector BBS          |
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|     [ ] I already have an account                                          |
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|     [ ] Set up my account with the following information:                  |
|                                                                            |
|         First __ __ __ __ __ __ __ __ __ __ __        (No aliases allowed) |
|                                                                            |
|         Last __ __ __ __ __ __ __ __ __ __ __                              |
|                                                                            |
|         Password __ __ __ __ __ __ __ __ __ __                             |
|                                                                            |
|         Birthdate __ __ / __ __ / __ __                                    |
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| Questions or comments:                                                     |
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| _________________________________________________________________________  |
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| _________________________________________________________________________  |
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| Suggestions for future projects:                                           |
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| _________________________________________________________________________  |
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| _________________________________________________________________________  |
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