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Text File  |  1993-12-13  |  1.6 KB  |  51 lines
  1.     (This form is provided for your convenience; it isn't required)
  2.  
  3.  
  4.     Name: ____________________________________________________________
  5.  
  6.  
  7.     Address: _________________________________________________________
  8.  
  9.  
  10.              _________________________________________________________
  11.  
  12.  
  13.              _________________________________________________________
  14.  
  15.     =====Fido Nodes Only=====
  16.     Fidonet Address:         _________________________________________
  17.  
  18.     Do you want to Freq the registration from 1:380/16?      [ Y / N ]
  19.  
  20.     Session Password:        _________________________________________
  21.     ==================================================================
  22.  
  23.  
  24.     Where you got FM/2: ____________________________ Version: ________
  25.  
  26.  
  27.     Preferred media:                ___ 5-1/4"               ___ 3-1/2"
  28.  
  29.  
  30.       _____ personal-use registration(s)    X    $35.00 ea. US
  31.  
  32.       _____ commercial-use registration(s)  X    $75.00 ea. US
  33.  
  34.       _____ shipping outside continental US X    $ 5.00 ea. US
  35.                                                  -------------
  36.  
  37.       _____ total registrations                 $__________ US enclosed
  38.                                                             no plastic
  39.  
  40.     Commments/Suggestions/Banter (include separate sheet if desired):
  41.  
  42.  
  43.     _________________________________________________________________
  44.  
  45.  
  46.     _________________________________________________________________
  47.  
  48.     Mail to:                  Mark Kimes
  49.                               542 Merrick
  50.                               Shreveport, LA  USA  71104
  51.