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/ Monster Media 1996 #14 / Monster Media No. 14 (April 1996) (Monster Media, Inc.).ISO / spitfire / fallcall.zip / LONE.REG < prev    next >
Text File  |  1996-01-14  |  2KB  |  47 lines
  1.                         FALLING STAR SOFTWARE
  2.                           REGISTERION FORM
  3.                        BBS - (515) 242-0129
  4.                 VOICE MAIL - (515) 242-0129
  5.                        FAX - (515) 242-0129
  6.  
  7.  
  8.     FULL NAME __________________________________________________
  9.  
  10.       
  11.       ADDRESS __________________________________________________
  12.  
  13.  
  14.       CITY ___________________STATE ____________ZIP CODE _____
  15.  
  16.  
  17.                 TELEPHONE NUMBER (___) ___-____                                 
  18.  
  19.                                              
  20.                                  SHAREWARE # _______
  21.  
  22.                                  FREEWARE  # _______
  23.            BBS NAME _________________________________________
  24.  
  25.            BBS DATA NUMBER (___) ___ -____ 
  26.                                                         
  27.                                                         AMOUNT __.__
  28.                                             
  29.                                            SHIPPING & HANDLING $2.00
  30.                                                                -----
  31.                                                          
  32.                                                          TOTAL __.__
  33.                                                         
  34.                      NO C.O.D OR CREDIT CARD                                   
  35.                      ONLY CASH,MONEY ORDER
  36.                            *******************
  37.                            *  MAKE MONEY TO  *
  38.                            * SCOTT DEFIBAUGH *
  39.                            *******************
  40.                          SEND
  41.                             To..Scott Defibaugh
  42.                                 3202 South Union
  43.                                 Des Moines,Ia 50315
  44.  
  45.                      Or Call Lone Star BBS For ON-LINE Registerion
  46.  
  47.