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Text File  |  1990-08-20  |  1KB  |  38 lines
  1.       
  2.                          PCBVERIFY REGISTRATION FORM
  3.                          ---------------------------
  4.  
  5.  
  6.       
  7.             Sysop name: _________________________________________ 
  8.  
  9.                Address: _________________________________________ 
  10.  
  11.       City, State, Zip: _________________________________________ 
  12.  
  13.      Home phone number: _________________
  14.  
  15.  
  16.       Board(s) to register:  (EXACTLY as you want it to appear on screen)
  17.       
  18.           ___________________________________     Phone: ___________
  19.  
  20.           ___________________________________     Phone: ___________
  21.                             
  22.           ___________________________________     Phone: ___________
  23.  
  24.  
  25.  
  26.  
  27.       Make your check for $15 payable to Curtis Kowalski and mail to:
  28.        
  29.       * NEW ADDRESS * --->   Curtis Kowalski
  30.                              PCBVerify Registration
  31.                              2312 Vincinda Circle
  32.                              Knoxville, Tn. 37924 
  33.                      
  34.       You  will  receive  your registration number a few days  after  I 
  35.       receive  your form.   If you do not receive a registration number 
  36.       after approximately 3 weeks, please contact Premier BBS @
  37.       (615) 522-2498.
  38.