home *** CD-ROM | disk | FTP | other *** search
/ DP Tool Club 8 / CDASC08.ISO / VRAC / LHI10.ZIP / ORDER.FRM < prev   
Text File  |  1993-05-03  |  1KB  |  49 lines
  1.                         
  2.                         
  3.                         
  4.                         
  5.                         
  6.                         NDo System Registration form 
  7.  
  8.  
  9.        Mail check or Money Order to:               Date___-___-___ 
  10.        Ken Byrd
  11.        Rt. 1, Box 15  
  12.        Rogersville, TN 37857
  13.  
  14.  
  15.             
  16.        Name: _____________________________________________________ 
  17.  
  18.        BBS Name: _________________________________________________
  19.  
  20.        Address: __________________________________________________ 
  21.  
  22.        City: ______________________ State: __________ ZIP: _______ 
  23.  
  24.        Voice: (   ) _________________ BBS: (   ) _________________
  25.  
  26.        BBS Hours: ____________
  27.        
  28.  
  29.  
  30.        Msg Central! version 2.01        $10.00            ________
  31.        
  32.        LHI version 1.0                  $10.00            ________
  33.  
  34.        (TN Residents please add 
  35.        8.75% sales tax)                                   ________
  36.                                                            
  37.        Total                                             $________ 
  38.  
  39.  
  40.  
  41.        Signature _________________________        Date ___-___-___
  42.  
  43.  
  44.                             BBS Support Conference  
  45.                
  46.                (804)483-3894   Naturpharm BBS  Before 7/1/93
  47.                (615)272-4606   Naturpharm BBS  After  7/15/93
  48.                (804)483-9882   The MailBox(tm) BBS
  49.