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/ Monster Media 1996 #15 / Monster Media Number 15 (Monster Media)(July 1996).ISO / bbs_game / grunt140.zip / GRUNT!.EXE / ORDERFRM.TXT < prev    next >
Text File  |  1996-04-28  |  4KB  |  55 lines
  1. +-----[ GRUNT! v1.040 (c)1996.]-----------------------------------------------+
  2. |                                                                             |
  3. |                    "GRUNT!" - REGISTRATION AND ORDER FORM                   |
  4. |                                                                             |
  5. | Your full legal name: _____________________________________________________ |
  6. |       (please print)       Last           First           MI                |
  7. |                                                                             |
  8. | Your mailing address: _____________________________________________________ |
  9. |                                                                             |
  10. |     Home Phone:(___) ___-____     _________________________________________ |
  11. |                                    City            State           Zip-Code |
  12. | Business Phone:(___) ___-____                                               |
  13. |                                                                             |
  14. | Internet Address: ________________________________________________________  |
  15. |                                                                             |
  16. | BBS Name: _____________________________________ Phone:(___) ___-____        |
  17. |                                                                             |
  18. | BBS Software: _____________________ Nodes: ____ Network: __________________ |
  19. |                                                                             |
  20. +-----------------------------------------------------------------------------+
  21. |                                                                             |
  22. |   Qty Product                                                Cost           |
  23. |   === ===================================================== =======         |
  24. |   ___ GRUNT! Registration Activation Key .................. $ 20.00         |
  25. |   --- ----------------------------------------------------- -------         |
  26. |                                                      Total: $______         |
  27. |                                                                             |
  28. |  1. Make your check/money order payable to "MICHAEL HOENIE".                |
  29. |  2. Please! - United States Currency Only!                                  |
  30. |  3. Mail your registration key and payment to:                              |
  31. |                                                                             |
  32. |                     POST OFFICE BOX 58401                                   |
  33. |                     SALT LAKE CITY, UTAH  84158-0401, (USA)                 |
  34. |                                                                             |
  35. +-----------------------------------------------------------------------------+
  36. |                                                                             |
  37. | NOTICE: This area MUST be filled out in DETAIL. The registration KEY that   |
  38. |         you will receive will contain your name, your BBS name, and your    |
  39. |         ID KEY code that you will punch in to GRUNTCFG. Whatever you put    |
  40. |         here will be hard coded into your registration key!                 |
  41. |                                                                             |
  42. |           NOTE: DO NOT USE MORE SPACES THAN THOSE ALLOWED BELOW.            |
  43. |                 YOU MUST USE YOUR REAL NAME AND FULL BBS NAME.              |
  44. |                 PLEASE PRINT LEGIBLY.                                       |
  45. |                                                                             |
  46. | YOUR NAME: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _      |
  47. |                                                                             |
  48. |  BBS NAME: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _      |
  49. |                                                                             |
  50. |  YES NO!                                                                    |
  51. |  [ ] [ ] Send my registration via. Internet (enter account above).          |
  52. |  [ ] [ ] Place me on the GRUNT! Internet Mailing List.                      |
  53. |                                                                             |
  54. +-----------------------------------------------------------------------------+
  55.