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Monster Media 1994 #1
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REGISTER.TXT
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1994-01-21
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3KB
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63 lines
BAJORAN TRIVIA REGISTRATION FORM - 1994
$15.00
.----------.___
/ | |||\ ~~~--_ ____
__|-------------| |~~~~~~~~----______--~~ ~~-_
| _|-_ |_| =============
|_| ~~---------'__\_____------~~~~~~--.______.-~
|__|~~ ~-__/ ~-_~-_
~--__ ~-__/ ~-_~-_ The NetWork That's "ALL" About Klingons!
~--__ ~-__/ ~-_~-_
~--__ ~-___/ ~-_ (tm) 1992 Klingon SoftWare Labs
~--__ ~-_
[__________]=====[[
USRobotics 14.4/HST
215-426-5596 24hrs Daily
FidoNet - 1:273/935 KlinNet - 126:6000/0
═══════════════════════════════════════════════════════════════════════════
MAIL THIS TO: Zenobia Ferguson Make Cheque/Money Order
Klingon SoftWare Labs payable to ZENOBIA FERGUSON
3421 N. Palethorp Street
Philadelphia, PA 19140-4625 VOICE: (215)426-6730
╔════════════════════════════════════╗
║-=- MAJOR CREDIT CARDS ACCEPTED! -=-║
║Visa - MasterCard - American Express║
╚════════════════════════════════════╝
Please enter BBS NAME and SYSOP NAME exactly how you want it shown from
within the door! Please print neatly.
YOUR NAME:_________________________________________
ADDRESS:___________________________________________
CITY/STATE:___________________ ZIPCODE:__________
BBS NAME:__________________________________________
BBS NUMBER:________________________________________
FIDONET ADDRESS:___________________________________
VOICE NUMBER:______________________________________
BBS SOFTWARE:______________________________________
BBS VERSION:_______________________________________
[ ] I would like to download my KEYS from your BBS (Klingon SoftWare Labs)
YOUR DATE OF BIRTH:______________________________
PASSWORD TO USE ON KLINGON SOFTWARE LABS:_____________________________
MONITOR TYPE: B/W___ MONO___ CGA___ EGA___ VGA___ SVGA___
Your Credit Card Number
┌─────────────┬───────────┬────────────┬──────────────┐
│ │ │ │ │ Exp.
└─────────────┴───────────┴────────────┴──────────────┘ Date ___________
If you wish to use a Credit Card, you have three options:
┌───────────────────────────────────────────────────────────────────────┐
│1) You may call in your credit card# at 215-426-6730 [Mon-Sat/10am-7pm]│
│2) Enter your credit card# on our support BBS (Door-6) at 215-426-5596 │
│3) Fill out this form and mail it to the above address │
└───────────────────────────────────────────────────────────────────────┘