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Text File  |  1996-01-22  |  2KB  |  58 lines
  1. _____<cut here>____________________________________________________________
  2. ╒════════════════════════════════════════════════════════════════════════════╕
  3. │▒▒▒ Super News Registration using your Credit Card ▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒│
  4. ╘════════════════════════════════════════════════════════════════════════════╛
  5.      **** IT'S NOT RECOMMENDED TO SEND IT AS ECHOMAIL OR NETMAIL ****
  6.    **** YOU MUST CRASH MAIL 4:801/51 OR ANY OTHER OF OUR ADDRESSES ****
  7.  
  8.                 Real Name: _____________________________
  9.                SysOp Name: _____________________________ [Case Sensitive]
  10.                  BBS Name: _____________________________ [Case Sensitive]
  11.      Your Mailing Address: _____________________________
  12.                            _____________________________
  13.                            _____________________________
  14.                Data Phone: _____________________________
  15.                 FAX Phone: _____________________________
  16.               Voice Phone: _____________________________
  17.                   FidoNet: _____________________________
  18.             Working hours: __:__ to __:__
  19.  
  20.         Credit Card to use: [ ] VISA
  21.                             [ ] MASTER CARD
  22.        
  23.        Credit Card Number: _____________________________
  24.        Credit Card Holder: _____________________________
  25.           Expiration Date: __/__   <- IMPORTANT!
  26.  Holder's Mailing Address: _____________________________
  27.                            _____________________________
  28.                            _____________________________
  29.  
  30.         Registration Fee: US$ 15.00 or R$ 15,00 (Brazilian Currency)
  31.  
  32.         For faster registration:
  33.         I want to receive my key through [ ] Crash Mail
  34.                                          [ ] FAX
  35.                                          [ ] Message on IRON BBS
  36.                                              Username: ____________________
  37.                                              Password: ____________________
  38.  
  39.         Please, send this form to:
  40.  
  41.          Fido: 4:801/51
  42.           RBT: 12:1213/4
  43.          SyNC: 30:1000/28
  44.         Panta: 67:1011/43
  45.      Canal100: 100:1011/51
  46.        Atomic: 72:1013/11
  47.  
  48.         or Money enclosed in a letter to:
  49.  
  50.         Super News Registration Department
  51.         Rua Jorge Tibirica 21/31
  52.         Santos - Sao Paulo - Brazil
  53.         11055-250
  54.  
  55. _____<cut here>____________________________________________________________
  56.      
  57.         Thanks for registering Super News
  58.