home *** CD-ROM | disk | FTP | other *** search
/ Media Share 9 / MEDIASHARE_09.ISO / private / dt_171.zip / SUBSCRPT.DOC < prev    next >
Text File  |  1993-08-22  |  2KB  |  44 lines
  1. DiscTrak System - Version 1.71
  2. Copyright (c)1992 Blam Entertainment Group, All Rights Reserved
  3. Vendor/BBS Subscription Form
  4.  
  5.  
  6.    Remit to:       Blaine R. Young
  7.                    Blam Entertainment Group
  8.                    707 Clark Court, #202
  9.                    Leesburg VA  22075              DATE _________________
  10.  
  11.   Current Revision ____________________    Compile Date _________________
  12.  
  13.  
  14.                                          Subscription
  15. Subscription Type                            Fee       QUANTITY  SUBTOTAL
  16. --------------------------------------- -------------- --------  --------
  17. Automatic Upgrades - select disk size         $5      x________  ________
  18.  
  19.   5-1/4  ________       3-1/2  ________          TOTAL ________  ________
  20.  
  21.  
  22. Company/BBS______________________________________________________________
  23.  
  24. Address__________________________________________________________________
  25.  
  26. _________________________________________________________________________
  27.  
  28. _________________________________________________________________________
  29.  
  30. Contact__________________________________________________________________
  31.  
  32. Phone _____________________________ (BBS)________________________________
  33.  
  34. Distribution Method______________________________________________________
  35.  
  36. *    Please make checks and/or Money Orders payable to Blaine R. Young.
  37. *    Checks and/or Money Orders MUST be drawn on U.S. banks,
  38.      payable in U.S. currency.
  39. *    All diskettes shipped will be low density.
  40. *    Fees listed above are per disk.  With each diskette received,
  41.      payment will be expected.
  42. *    This option is valid until terminated in writing.  You must make
  43.      timely payments of per disk fees to keep the subscription valid.
  44.