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Text File  |  1996-09-29  |  1KB  |  47 lines
  1. ---------------------------=> Registration Form <=----------------------------
  2.   Registration Form for:
  3.     BJ4TOP Version 2.00
  4.     Copyright 1996 Paul Sidorsky, ISMWare
  5.     All Rights Reserved
  6.  
  7. Full Name: _______________________________________
  8.  
  9. Address: _________________________________________
  10.  
  11. City: ____________________________________________
  12.  
  13. Province/State: __________________________________
  14.  
  15. Country: ____________  Postal Code: ______________
  16.  
  17. Date Sent (MM/DD/YY): ____/____/____
  18.  
  19. Bulletin Board/System Name: ______________________
  20.  
  21. Bulletin Board Phone Number: _____________________
  22.  
  23. BBS Mail addresses: ______________________________
  24.  
  25. Delivery method:  [  ] Call my BBS    [  ] FidoNet    [  ] Postal mail
  26.  
  27.                                  [ Cost ]
  28.  
  29.     The cost of registering BJ4TOP is $15.00.
  30.  
  31. Method of Payment:
  32.  
  33.          [  ]  Cheque drawn on a Canadian bank
  34.                (Must be for the amount shown above in CDN funds)
  35.  
  36.          [  ]  Cheque drawn on a US bank
  37.                (Must be for the amount shown above in US funds)
  38.  
  39.          [  ]  Money Order
  40.  
  41. Send this to:  BJ4TOP Registration
  42.                c/o Paul Sidorsky
  43.                1414 45th Street SW
  44.                Calgary, AB
  45.                CANADA    T3C 2C2
  46.  
  47.