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Text File  |  1994-06-10  |  3KB  |  56 lines
  1.  
  2.  
  3.               ===================================================
  4.               Express Call-Back Verifier (XCBV) REGISTRATION FORM
  5.               ===================================================
  6.  
  7.     Using a text editor, please fill in the information below (inside the
  8.     brackets).  When done, print out, SIGN THE FORM, and mail it along with
  9.     your payment (check or money order payable to Phil Baggett) to this
  10.     address:
  11.  
  12.                             Phil Baggett
  13.                             Betatron Intl.
  14.                             2775 NE Expressway #3-1
  15.                             Atlanta, GA  30345
  16.  
  17.     SysOp name/handle and BBS name will appear on opening screen of program
  18.     exactly as given below.  See XCBV.DOC for more information.
  19.     ------------------------------------------------------------------------
  20.  
  21.     Program Version Number:  [ .  ]
  22.  
  23.     SysOp Real Name and Address:  [                                        ]
  24.                                   [                                        ]
  25.                                   [                                        ]
  26.                                   [                                        ]
  27.  
  28.     Voice Phone:  [   -   -    ]                    Birthdate:  [  /  /    ]
  29.     Best time to call, if necessary:  [                                    ]
  30.  
  31.     SysOp Name or Handle:  [                                        ]
  32.                 BBS Name:  [                                        ]
  33.  
  34.     BBS Phone:  [   -   -    ]    Hours:  [                                ]
  35.     Month/Year BBS was started:  [  /    ]
  36.  
  37.     Specifically, where did you get this evaluation version?
  38.     [                                                                      ]
  39.  
  40.     Comments:  [                                                           ]
  41.                [                                                           ]
  42.                [                                                           ]
  43.  
  44.     Check desired disk size:  [ ] 3.5" 1.44M   [ ] 3.5"  720K
  45.                               [ ] 5.25" 1.2M   [ ] 5.25" 360K
  46.  
  47.     Check enclosed amount:  [ ] $20
  48.  
  49.     Enclosed is my registration fee for XCBV.  I understand and agree that
  50.     the author's disclaimer in the accompanying XCBV.DOC file applies to the
  51.     registered version, as well as the evaluation version, of the program.
  52.  
  53.  
  54.     Date:  [  /  /    ]              Signed:  ______________________________
  55.                                                     SIGNATURE REQUIRED
  56.