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/ Monster Media 1996 #15 / Monster Media Number 15 (Monster Media)(July 1996).ISO / bbs_game / 8linev20.zip / REG.FRM < prev    next >
Text File  |  1996-03-31  |  1KB  |  54 lines
  1.  
  2.                               REGISTRATION FORM
  3.                               +++++++++++++++++
  4.  
  5.    
  6.    
  7.    Name        _______________________________________________
  8.  
  9.  
  10.    Street      _______________________________________________
  11.  
  12.  
  13.    State/Prov  _______________________________________________
  14.  
  15.  
  16.    Country     _______________________________________________
  17.  
  18.  
  19.    Zip Code    _______________________________________________
  20.    
  21.    
  22.    BBS Name    _______________________________________________
  23.  
  24.  
  25.    BBS Number  _______________________________________________
  26.  
  27.  
  28.    Fido        _______________________________________________
  29.  
  30.  
  31.  
  32.    Program and Version You Wish To Register:                            
  33.    
  34.  
  35.                ________________________________________________
  36.  
  37.  
  38.    Would you like your Reg# posted on Dog's BBS - Circle >  Yes  or  No
  39.  
  40.    
  41.    If (Yes) Enter Your Password Here > ________________________________
  42.  
  43.  
  44.                                   Mail $15 To:
  45.  
  46.                                   Barry Webb
  47.                                1020 Somerset St. A1
  48.                                 Saint John, N.B.
  49.                                    Canada
  50.                                    E2K 2Y7
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