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- ARROWBRIDGE v1.20a
- NORTH AMERICAN REGISTRATION FORM
- -----------------------------
- (Please Print)
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- Registered to:___________________________________________ E-MAIL ________
- (BBS Name or User Name if for private use)
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- First Name :____________________ Last Name:______________________________
- (User Name - MUST be completed)
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- Address:_______________________________________________________________
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- City:____________________________ State:___ Zip Code:_______Country_______
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- Home Phone: ( )____-______ Fax Number: ( )____-______
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- Cost For Registering Arrowbridge I (For BBS or Private Registrations only)
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- $ 14.00 in U.S. funds OR $ 19.00 in CANADIAN funds
- (payable by bank draft, money order or credit card)
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- Please register your copy of Arrowbridge with FIREBURNERS BBS. Make bank
- drafts, cheques or money orders payable to "Fireburners BBS Online, inc."
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- CREDIT CARD ORDERS:
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- Fill out your credit card information and mail this
- form to the address listed below.
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- Type of Credit Card: MasterCard VISA AMEX DISCOVER
- (Circle one)
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- Credit Card Number : _____________________________________
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- Expiration Date : _________
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- Name as it appears on card: _____________________________________
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- Signature : ____________________________
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- (not necessary for Crash Mailed forms)
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- _______________________________________________________________________________
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- CHECKS & POSTAL ORDERS
- All checks and postal orders should be made out to "FireBurners BBS Online, Inc."
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- FireBurners BBS Online
- 154 N.E. 4th St
- Toledo, Oregon 97391
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- You may also register online by Credit Card by calling FireBurners BBS Online at 541-336-4538.
- Enter "O" at the Main Menu.
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- ORDERS BY FAX
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- Please fax this form with your Credit Card Information to 541-336-4708.
- Your registration code will be sent back to you via fax.
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- _____________________________________________________________________________
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