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Text File  |  1995-10-07  |  2KB  |  59 lines

  1.  
  2.                        Registration form for Xtruder
  3.                        =============================
  4.  
  5.     The following personal data will only be seen and stored by the author
  6.     of Xtruder, Martin Wulffeld, and will NOT be made accessible to anyone
  7.     else.
  8.  
  9.     If you have printed this PLEASE WRITE LEGIBLY!
  10.  
  11. -----------------------------------------------------------------------------
  12.  
  13.                     Full name:______________________________________
  14.  
  15.                  Full address:______________________________________
  16.  
  17.                               ______________________________________
  18.  
  19.                               ______________________________________
  20.  
  21.                               ______________________________________
  22.  
  23.                               ______________________________________
  24.  
  25.          Private phone number:+___-(____)-_________________
  26.  
  27.            E-Mail address(es):______________________________________
  28.  
  29.                               ______________________________________
  30.  
  31.                               ______________________________________
  32.  
  33.               FidoNet address:______________________________________
  34.  
  35.                AmyNet address:______________________________________
  36.  
  37.       Complaints, wishes etc.:______________________________________
  38.  
  39.                               ______________________________________
  40.  
  41.                               ______________________________________
  42.  
  43.   Would you like your name on       _        _
  44.     the registered users list: Yes |_|   No |_|
  45.  
  46.       Your version of Xtruder:__.__
  47.  
  48.        Your Kickstart version:__.___
  49.                                     _        _
  50.              Do you run a BBS: Yes |_|   No |_|
  51.  
  52.            Tick the following:
  53.                                 _                               _
  54.                    I pay cash: |_|    I pay via bank transfer: |_|
  55.  
  56. -----------------------------------------------------------------------------
  57.  
  58.    REFER TO MAIN DOCUMENTATION FOR THE FULL DETAILS ON HOW TO REGISTER.
  59.