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Text File  |  1994-05-11  |  2KB  |  111 lines
  1. ORDER FORM FOR THE GUEST REGISTRY
  2.  
  3.     Send order form to:
  4.  
  5.         Jimmy Rose
  6.         2000 Linden Ave.
  7.         Middletown, OH
  8.         45044-4435
  9.     USA
  10.  
  11.         $12 to register The Guest Registry ($10 + $2 P/H)
  12.  
  13.  
  14.         >>> Make Check or Money Order payable to: Jimmy Rose <<<
  15.  
  16.  
  17.                             ORDER FORM
  18.  
  19. ---------------------------- CUT HERE ----------------------------------
  20.  
  21.                        PLEASE PRINT CLEARLY
  22.  
  23.  
  24.     Name:_____________________________________________________
  25.  
  26.  
  27.     Company:__________________________________________________
  28.  
  29.  
  30.     Street address:___________________________________________
  31.  
  32.  
  33.     City:___________________________ ZIP code:________________
  34.  
  35.  
  36.     Country:__________________________________________________
  37.  
  38.  
  39.                  The following information is optional
  40.  
  41.  
  42.         Phone:________________________ FAX:_______________________
  43.  
  44.  
  45.     Age:_____________ Occupation:_____________________________
  46.  
  47.  
  48.  
  49.  
  50. **      Following are network addresses for various networks,
  51. **      If you have an address for a network please enter it:
  52.  
  53.         FidoNet:__________________________________________________
  54.  
  55.  
  56.     InterNet:_________________________________________________
  57.  
  58.  
  59.         CompuServe:_______________________________________________
  60.  
  61.  
  62.     Other:____________________________________________________
  63.  
  64.  
  65. **      If you operate a BBS, fill out the next fields:
  66.  
  67.  
  68.     BBS name:________________________________________________
  69.  
  70.  
  71.         BBS phone number(s):
  72.  
  73.     _________________________________________________________
  74.  
  75. **      Please tell us about your computer:
  76.  
  77. **      Machine type:
  78.  
  79.     [ ]     386SX           Processor speed:________MHz
  80.     [ ]     386DX
  81.         [ ]     486SX           Type of Printer:___________
  82.     [ ]     486DX
  83.         [ ]     Pentium
  84.     [ ]     other:__________________________
  85.  
  86.     RAM:_______MB           Harddisk:________MB
  87.  
  88.  
  89. **      Please tell us where you discovered The Guest Registry
  90.  
  91.         ________________________________________________________
  92.  
  93.  
  94.         ________________________________________________________
  95.  
  96.  
  97.         ________________________________________________________
  98.  
  99. **      Please insert your comments about The Guest Registry
  100.       
  101.  
  102.     _________________________________________________________
  103.  
  104.  
  105.     _________________________________________________________
  106.  
  107.  
  108.     _________________________________________________________
  109.  
  110.  
  111.