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Text File  |  1993-11-15  |  3KB  |  40 lines
  1.  
  2.  
  3.  
  4.                   THDUTL Registration Form      Mail to:
  5.  
  6.                           H. D. Holland
  7.                           2911 Chestnut Grove Dr.
  8.                           Austell, Ga. 30001-000
  9.  
  10. +----------------------------------------------------------------------------+
  11. |                                                                            |
  12. | Name:___________________________________[ ] THDUTL Registration $25.00US ea|
  13. |                                                                            |
  14. | Address:________________________________                                   |
  15. |                                                                            |
  16. | City:___________________ State:_________                                   |
  17. |                                                                            |
  18. | Zip Code:_______________ Zip+4:_________                                   |
  19. |                                                                            |
  20. | Make checks payable to: H. D. Holland        Total Enclosed    $_____.___  |
  21. |                                                                            |
  22. | What is the name of your BBS?                                              |
  23. |                           Name __________________________________________  |
  24. |                           Phone number:       (_____)____-_________        |
  25. |                                                                            |
  26. | Where did you get THDUTL                                                   |
  27. | [] Local BBS              Name __________________________________________  |
  28. |                           Their phone number: (_____)____-_________        |
  29. |                                                                            |
  30. |                           [] Other ______________________________________  |
  31. |                                                                            |
  32. | [] Directly from me                                                        |
  33. |                                                                            |
  34. | [] Friend                 Name __________________________________________  |
  35. |                                                                            |
  36. | [] Shareware outlet house Name __________________________________________  |
  37. |                                                                            |
  38. +----------------------------------------------------------------------------+
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