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Text File  |  1995-02-21  |  1KB  |  41 lines
  1.                         
  2.  
  3.                                 Registration Form
  4.  
  5.  
  6. Name: ________________________________________________________________
  7.  
  8. BBS name: ____________________________________________________________
  9.  
  10. Street: ______________________________________________________________
  11.  
  12. City: ____________________ State: ______ Zip code: ___________________
  13.  
  14. Country: _____________________________________________________________
  15.  
  16. Phone: _______________________________________________________________
  17.  
  18. Program registering: _________________________________________________
  19.  
  20. Type of disk: 3 1/2: ____________________ 5 1/4: _____________________
  21.  
  22. Computer: ____________________________________________________________
  23.  
  24. On-line service or BBS's: ____________________________________________
  25.  
  26. ______________________________________________________________________
  27.  
  28. Where did you get the program: _______________________________________
  29.  
  30. ______________________________________________________________________
  31.  
  32. Amount enclosed: _____________________________________________________
  33. * Add $1.00 shipping to Canada and Mexico. Add $3.00 shipping to 
  34.   anywhere outside of North America.
  35.  
  36. Send to:
  37.                 
  38.                 Burnham Park Software, Inc.
  39.                 P.O. Box #814
  40.                 Chicago, IL 60690-0814
  41.