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Text File  |  1992-06-08  |  5KB  |  65 lines
  1. +-------------------------------------------------------------------------+
  2. | T E C H N O       T R I V I A      R E G I S T R A T I O N      F O R M |
  3. +-------------------------------------------------------------------------+
  4. |                                                                         |
  5. | Your Name _____________________________________________________________ |
  6. |                                                                         |
  7. | BBS Name ______________________________________________________________ |
  8. |                                                                         |
  9. | Street Adress _________________________________________________________ |
  10. |                                                                         |
  11. | City, State and Zip Code ______________________________________________ |
  12. |                                                                         |
  13. | Country _______________________________________________________________ |
  14. |                                                                         |
  15. | BBS Phone (____) _______-_________    FIDO Address  ___:_______/_______ |
  16. |                                                                         |
  17. | Suggestions/Comments/Bugs _____________________________________________ |
  18. |                                                                         |
  19. | _______________________________________________________________________ |
  20. |                                                                         |
  21. |                Please Select The Options You Would Like:                |
  22. |                                                                         |
  23. |              [ ]  Basic Registration Fee....$15.00                      |
  24. |                   (Includes Game & General I Question Pack)             |
  25. |                                                                         |
  26. |              [ ]  Intermediate Registration.$20.00   - Save $10         |
  27. |                   (Includes Game & General I-IV Question Packs)         |
  28. |                                                                         |
  29. |              [ ]  Advanced Registration.....$40.00   - Save $30         |
  30. |                   (Includes Game & All 11 Question Packs)               |
  31. |                                                                         |
  32. |              [ ]  Upgrade From Old Version..$7.50    - Save $7.50       |
  33. |                                                                         |
  34. |              [ ]  3 1/2" Low Density Disk...$1.00                       |
  35. |                                                                         |
  36. |             +---------------------------------------+                   |
  37. |             |         Single Question Packs         |                   |
  38. |             +---------------------------------------+                   |
  39. |             |  [ ]  General II               $5.00  |                   |
  40. |             |  [ ]  General III              $5.00  |                   |
  41. |             |  [ ]  General IV               $5.00  |                   |
  42. |             |  [ ]  Music I                  $5.00  |                   |
  43. |             |  [ ]  Music II                 $5.00  |                   |
  44. |             |  [ ]  Brain-Strain I           $5.00  |                   |
  45. |             |  [ ]  Brain-Strain II          $5.00  |                   |
  46. |             |  [ ]  The 80's                 $5.00  |                   |
  47. |             |  [ ]  The 60's                 $5.00  |                   |
  48. |             |  [ ]  Disney I                 $5.00  |                   |
  49. |             |  [ ]  Disney II                $5.00  |                   |
  50. |             +---------------------------------------+                   |
  51. |                     Grand Total         | $         |                   |
  52. |                                         +-----------+                   |
  53. |                                                                         |
  54. +-------------------------------------------------------------------------+
  55. +-------------------------------------------------------------------------+
  56. |                 Print This Form, Fill Out, And Mail To:                 |
  57. |                                                                         |
  58. |                          Player's Choice Software                       |
  59. |                          c/o David Mitchell                             |
  60. |                          36205 6 Mile Road                              |
  61. |                          Livonia, MI 48152                              |
  62. |                                                                         |
  63. |                (Make Checks Payable To DAVID MITCHELL)                  |
  64. +-------------------------------------------------------------------------+
  65.