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Text File  |  1995-06-21  |  577b  |  24 lines
  1.               -==(APPLICATION FORM FOR WIRED'95 BUSTRIP)==-
  2.  
  3.  
  4.       HANDLE: _________________
  5.    REAL NAME: _________________
  6.        D.O.B: XX/XX/XXXX
  7.  FULL ADRESS: _________________
  8.               _________________
  9.               _________________
  10.  
  11.  
  12. PHONE NUMBER: _________________
  13.  
  14. KIND OF PAYMENT:
  15.      I INCLUDED THE MONEY IN THIS ENVELOPE        ( )
  16.      I TRANSFERED THE MONEY TO YOUR BANK ACCOUNT  ( )        
  17.                                      ( PLACE AN 'X'!)
  18.  
  19. I AGREE TO ALL AGREEMENTS MENTIONED IN BUSTRIP.TXT
  20.  
  21. SIGNATURE:
  22.  
  23.          ----------
  24.