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Text File  |  1992-04-08  |  2KB  |  63 lines
  1.  
  2.  
  3.                       *** WCFF! v3.50 Registration Form ***
  4.  
  5.                             Online Computer Resources
  6.                                4330-J Clayton Road
  7.                                Concord,  CA  94521
  8.                               Voice: (510) 687-1122
  9.                               Data : (510) 687-0236
  10.  
  11.  
  12.           Name    : __________________________________________________
  13.  
  14.           Company : __________________________________________________
  15.  
  16.           BBS Name: __________________________________________________
  17.  
  18.           Address : __________________________________________________
  19.  
  20.           City    : ______________________  State: ___  Zip: _________
  21.  
  22.           (Voice) : (____) ____-_______    Wildcat! Version:  S  M  P
  23.  
  24.           (DATA)  : (____) ____-_______    Wildcat! Reg #  :  __-_____
  25.  
  26.           Comments:___________________________________________________
  27.  
  28.           ____________________________________________________________
  29.  
  30.           ____________________________________________________________
  31.  
  32.           ____________________________________________________________
  33.  
  34.  
  35.           Please select the appropriate payment method:
  36.  
  37.                            [ ] Check Enclosed *
  38.                            [ ] VISA
  39.                            [ ] MasterCard
  40.                            [ ] Discover Card
  41.                            [ ] Other (Cash, M/O etc)
  42.  
  43.           * If payment is made by check, a 10 day hold will be placed
  44.             on all orders until the check clears.
  45.  
  46.  
  47.           Name on Card: _____________________________
  48.  
  49.           Card Number : _____________________________  Exp Date: _____
  50.  
  51.           Signature   : _____________________________
  52.  
  53.  
  54.           WCFF! v3.50..........................................$ 25.00
  55.  
  56.           CA residents please add 8.25% sales tax..($2.06).....$ _____
  57.  
  58.           Shipping and Handling................................$  2.00
  59.  
  60.  
  61.                                                         TOTAL  $ _____
  62.  
  63.