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Text File  |  1992-12-03  |  1.2 KB  |  45 lines
  1.  
  2.                   PCB-REWARD REGISTRATION FORM
  3.                   
  4.  
  5.  Name:___________________________________________________
  6.  
  7.  BBS Name:_______________________________________________ 
  8.  
  9.  Address:________________________________________________
  10.  
  11.  City:___________________________________________________
  12.  
  13.  State:____________
  14.  
  15.  Zip:______________
  16.  
  17. BBS Phone:________________
  18.  
  19. Voice Phone:_______________
  20.  
  21. BBS Name or Name you wish to make registration in:
  22.  
  23.      ------------------------------------------------------
  24.     (Note: Spell exactly as you wish it to appear.  Caps Count!
  25.            PLEASE PRINT)
  26.  
  27. Please enclose the registration fee of $10.00 and mail it to the
  28. address below.  I will then send you the registration number via
  29. mail.  Future upgrades will be made available on Software HEaven
  30. BBS.  This registration number will be good for all future
  31. releases.
  32.  
  33. MAKE CHECKS PAYABLE TO :  Tom Gregory
  34. -------------------------------------
  35.  
  36.  
  37.  Mailing address:  Tom Gregory
  38.                    PCB-REWARD REGISTRATION
  39.                    5278 Tracy Ct.
  40.                    Stone Mountain, GA. 30083
  41.                    
  42.                    (404)-413-6579
  43.                    
  44.                    
  45.