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Text File  |  1992-11-07  |  2KB  |  55 lines
  1.  
  2.                            -- FIDOBILL REGISTRATION --
  3.                                    -- v2.08 --
  4.  
  5.            Network To Register:   ______  ______
  6.                                   (Zone)  (Net)
  7.  
  8.                 Today's Date:  _____/_____/_____
  9.                                Month  Day   Year
  10.  
  11.            Accountant's Name:  ______________________________________
  12.  
  13.                      Address:  ______________________________________
  14.  
  15.                         City:  ______________________ State: ________
  16.  
  17.                          Zip:  ________             Country: ________
  18.  
  19.                  Voice Phone:  (____) ______ - __________
  20.  
  21.                       -- CREDIT CARD INFO (IF APPLICABLE) --
  22.  
  23.              Cardholder Name: _______________________________________
  24.  
  25.       VISA/MC Account Number: _______________________________________
  26.  
  27.         Card Expiration Date: _____/_____
  28.                               Month  Year
  29.  
  30.            FidoNet Address To Send Key To: ________________
  31.  
  32.      Is your network funding this registration? _______
  33.  
  34.      I have enclosed $40.00 (U.S.) drawn on a U.S. bank for FIDOBILL
  35.      registration.  I understand that by signing below I agree to any
  36.      and all terms of usage of FIDOBILL, which include:
  37.           1. I will not resell the software key I receive.
  38.           2. I will not try to de-compile or reverse engineer FIDOBILL.
  39.           3. I will not distribute FIDOBILL in any form other than as
  40.              the complete package as I received it.
  41.           4. I recognize that the software key is registered to my net
  42.              and not myself (unless you specifically request otherwise).
  43.           5. If paying by credit card I certify that I am authorized
  44.              to request that Vault Information Services charge US$40.00
  45.              to the account specified above.  I understand a credit
  46.              card charge receipt will be mailed to the address I have
  47.              indicated above.
  48.  
  49.  
  50.                     ________________________________________
  51.                     Signature of Applicant              Date
  52.  
  53.      Send registrations to: Craig Steiner, 3827 E. Easter Drive
  54.                             Littleton, CO 80122, USA
  55.