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Text File  |  1992-10-18  |  2.0 KB  |  67 lines
  1.  
  2.  
  3.    Registration for: FFG v1.04.a       Send to:  Maelstrom Software
  4.    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~       ~~~~~~~~  PO Box 57342
  5.                                                  Webster TX
  6.    Info on your BBS                              77598-7342
  7.    ~~~~~~~~~~~~~~~~
  8.      Name of BBS you run?   __________________________________________
  9.  
  10.      FIDO node number?      ___:_____/______    Other: ___:_____/_____
  11.  
  12.      BBS Phone Number(s)    ___________________     __________________
  13.  
  14.                             ___________________     __________________
  15.  
  16.  
  17.    Some info on you  (all correspondence is confidential)
  18.    ~~~~~~~~~~~~~~~~
  19.      Name           ___________________________
  20.  
  21.      Street/PO Box  __________________________________________________
  22.  
  23.      City           ___________________________ State ________________
  24.  
  25.      Zip            ___________   Voice # (Optional) _________________
  26.  
  27.      Products you'd like to see ______________________________________
  28.  
  29.      _________________________________________________________________
  30.  
  31.  
  32.    Payment
  33.    ~~~~~~~
  34.      Please check one item below and enclose $11 US funds only:
  35.  
  36.      [  ]  Check           [  ]  Cash       [  ] Money Order/Cashiers Check
  37.  
  38.      [  ]  MasterCard      [  ] Visa        [  ] Discover
  39.  
  40.      [  ]  JCB/Carte Blanche/Diners Club
  41.  
  42.  
  43.      If credit card:   Name on Card: _________________________________
  44.  
  45.                        Expiration (MM/YY): ____/____
  46.  
  47.                        I do hereby authorize Kit Cragin, dba Maelstrom Online
  48.                        Services to charge my credit card $11 US funds.
  49.  
  50.                        ___________________________________  __________
  51.                        Signature                            Date
  52.  
  53.    Check writers: orders processed when check clears.  Bad checks are
  54.                   subject a to $15 processing fee.
  55.  
  56.  
  57.    COMMENTS/SUGGESTIONS   (considered for future releases)
  58.    ~~~~~~~~~~~~~~~~~~~~
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