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  1.                                     BGFAX2FD v1.00
  2.                                   Registration Form
  3.  
  4.           First Name : ______________________________________________
  5.  
  6.           Last Name: ________________________________________________
  7.  
  8.           Mailing Address: __________________________________________
  9.  
  10.           ___________________________________________________________
  11.  
  12.           ___________________________________________________________
  13.  
  14.           Country: __________________________________________________
  15.  
  16.           Home Phone: (____)____________
  17.  
  18.  
  19.           Your BBS information: 
  20.           ~~~~~~~~~~~~~~~~~~~~~
  21.  
  22.           BBS Name: __________________________________________________
  23.  
  24.           BBS Phone: (____)____________ Fido Address: __________________
  25.  
  26.  
  27.           Registration Type
  28.           ~~~~~~~~~~~~~~~~~
  29.                                   Please Circle One
  30.                                   ~~~~~~~~~~~~~~~~~
  31.  
  32.                          3.5"           5.25"          Fidonet
  33.                       Diskette        Diskette        Crashmail
  34.  
  35.              USA or CANADA                            OTHERS
  36.           ~~~~~~~~~~~~~~~~~~~                       ~~~~~~~~~~
  37.           BGFAX2FD : $  5.00                     BGFAX2FD : $ 5.00
  38.           Shipping : $  2.50                     Shipping : $ 4.50
  39.  
  40.           TOTAL    : $_______                    TOTAL  : $______
  41.  
  42.  
  43.           Now please make out a check or money order in US FUNDS ONLY
  44.           for the TOTAL to:
  45.  
  46.                                    Keith Mitchell
  47.  
  48.                   Then mail it with this form to the following address:
  49.  
  50.                                    KAM Software
  51.                                    6000 College Dr #102
  52.                                    Suffolk, VA 23435-2064
  53.                                    USA
  54.