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                          LightChat Registration Form
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       See ORDERING.TXT for local prices and support BBS details.


       SysOp Name   :  _______________________________________ (required)

       BBS name     :  _______________________________________ (required)

       Address      :  __________________________________________________

                       __________________________________________________

                       __________________________________________________


       FidoNet address  :  ______________________________________________

       Internet e-mail address : ________________________________________


       Key obtained by : ( ) Crash netmail    ( ) Call to support BBS
                         ( ) Internet e-mail

       Options         : ( ) Printed manual*  ( ) Key/disk by post*

       Payment method  : ( ) Cash             ( ) Cheque/EuroCheque
                         ( ) Credit Card      ( ) Postal Order/IMO
                         ( ) CompuServe       ( ) Bank Transfer


       Amount       : _________________ (in registration site's currency)


       Credit Card #: _______________________________   Expires: ___/___

       Name on card : _______________________________   (EXACTLY as it
                                                        appears on card)
       Signature    : _______________________________


       * indicates additional charge - see ORDERING.TXT


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