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Text File  |  1994-02-07  |  4KB  |  77 lines
  1.                               Registration Form
  2.                Please support shareware by making your payment.
  3.                         Remit To:     Robert Neal        
  4.                                       317 Hickory
  5.                                       Romeoville, IL  60441
  6. --------------------------------------------------------------------------
  7.     PROGRAM NAME                                        PRICE    AMOUNT
  8.  
  9. [ ]  BBS Bowling Solitaire v1.2                        $14.95   ________
  10. [ ]  Card Sharks BBS Door v5.8                         $14.95   ________
  11. [ ]  CD ROM Duplicate File Analyzer v1.3               $ 9.95   ________
  12. [ ]  CD ROM File Date Analyzer v1.0                    $ 9.95   ________
  13. [ ]  DaLabeler v4.8                                    $14.95   ________
  14. [ ]  DizIt v3.2                                        $ 9.95   ________
  15. [ ]  Links Country Club Golf BBS Door v4.0             $14.95   ________
  16. [ ]  PCBoard User Ratio Monitor v1.6                   $14.95   ________
  17. [ ]  Z-Wordz BBS Door v2.1                             $14.95   ________
  18.  
  19. [ ]  Current version of programs selected on disk      $ 5.00   ________
  20.         Disk size: [ ] 5.25"-High Density   [ ] 3.5"
  21.  
  22. LESS: Volume Discount/# programs ordered (min 2) ____ @ $3.00   ________
  23.         A 20%+ discount for each program ordered             ___________
  24.  
  25.                                                 TOTAL          $
  26.                                                                 ========
  27. Please indicate method of receiving your registration key:
  28.         [ ] - Provide registration key via private message on
  29.                 support BBS (815) 886-3233 or (815) 886-9381
  30.         [ ] - Provide registration key via US Mail
  31.  
  32. ----------------------------------------------------------------------------
  33. ** Payment by Check (US Bank or branch), Money Order or Credit Card Only **
  34.  
  35. Complete if paying by credit card (Visa/Mastercard only):
  36.  
  37. [ ]-Visa        CARD #: _______________________________  EXP DATE: ___/___
  38. [ ]-MasterCard
  39.                 SIGNATURE:  ____________________________________
  40.  
  41. Use your Visa/MasterCard to register online - simply call the support
  42. BBS at (815) 886-3233 or (815) 886-9381. Type CHARGE at main menu prompt.
  43. -----------------------------------------------------------------------------
  44.  
  45.    Name: _________________________________
  46.    
  47. Address: _________________________________
  48.  
  49.          _________________________________
  50.          
  51. BBS Name to enter in registration (30 char max)          Phone number
  52.  
  53.  _______________________________________            (    ) _____ - ________  
  54.  
  55. Baud Supported: _______              BBS software used: ___________________    
  56. ---------------------------------------------------------------------------
  57. Fold at the page break below with the printing facing out.  Then fold
  58. letter style, exposing the mailing address and hiding your information.
  59. If necessary, staple check to the mailer, then staple or tape sides and top.
  60.  
  61. _________________________________                                     Place
  62.  
  63. _________________________________                                     Stamp
  64.  
  65. _________________________________                                     Here
  66.  
  67.  
  68.  
  69.  
  70.  
  71.                                          Robert Neal         
  72.                                          317 Hickory         
  73.                                          Romeoville, IL  60441    U.S.A.
  74.  
  75.  
  76.  
  77.