Registration Form ($10)

            (Add $2 to get latest copy uploaded to your bbs)

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Print or Type:


   Real Name: ____________________________________________________________

   Alias: ________________________________________________________________

   Name of your BBS: _____________________________________________________

   Select the name you want your registered copy to display:

              ( ) Alias     ( ) Real Name     ( ) BBS name

   Street Address:    ____________________________________________________

   City, State, ZIP:  ____________________________________________________

   BBS phone number:  (_____)  ______ - __________

   Voice phone number:  (_____)  ______ - __________

   Current version of mErDIT: _________

   Date of MERDIT.EXE: _________

   If applicable:  WWIVLink node @ _________

                   WWIVnet node @ _________

                   ____________ node @ _________

   Amount Enclosed: $_________

If you wish to have an account on my bbs, so you can download mErDIT, fill out
the following:

   Username: _____________________________________________________________

   Password: _____________

   I will use the voice phone number you supplied above.

Create an account for me and fill out the following if you are requesting an
upload:

   Username/number: Merdion #_________

   Password: _____________

   Phone Number: 410-939-9139

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     The cost of registration is $10.  Add $2 if you wish me to call your bbs
and upload the latest version.  Please send check or money order.  Your
registration number will be mailed to or will be left as e-mail if you
requested an upload.

Mail to:    Timothy Gion
            809 S. Washington Street
            Havre de Grace, MD  21078-3613

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