home *** CD-ROM | disk | FTP | other *** search
/ Cream of the Crop 12 / Cream of the Crop 12 (Part II) / Cream of the Crop 12 (Part II).iso / BBS / CHNRT192.ZIP / REGISTER.FRM < prev    next >
Encoding:
Text File  |  1996-05-05  |  3.6 KB  |  75 lines
  1.                                REGISTRATION FORM
  2.                                       for
  3.                                  CHAIN REACTION
  4.                             (c)1995-1996 Mace Software
  5.  
  6.         BBS NAME....................................................
  7.                   
  8.         BBS PHONE...................................................
  9.         
  10.         SYSOP'S First and Last Name.................................
  11.  
  12.         Street Address..............................................
  13.  
  14.         CITY, STATE..............................ZIP CODE...........
  15.  
  16.         DAYTIME VOICE PHONE (Optional) .............................
  17.         (must be included for credit card orders)
  18.  
  19.         How do wish to obtain your registered copy: Circle One:
  20.           > US Mail - Will be mailed three days after payment recieved
  21.           > Via FidoNet - Your Fido Address...........................
  22.           > Download from FBN BBS - If you choose this method, I will
  23.                 (304)725-1957       set up an account for you using the
  24.                                     First and Last Name above. What
  25.                                     password would you like to use.
  26.                                     (4-8 characters)....................
  27.  
  28.         REGISTRATION FEE ONLY!!!................................. $10.00
  29.           (price valid thru 6/1/97. Afterwards, contact Mace Software)
  30.  
  31.                      Please send check or money order to:
  32.                                  Gary Mace
  33.                              63 Cloverdale Hts.
  34.                              Charles Town, WV
  35.                                    25414
  36.  
  37.                                     OR
  38.  
  39.         I CAN NOW ACCEPT CREDIT CARD ORDERS FOR ALL MAJOR CREDIT CARDS.
  40.         Please note that due to the processing fees, an additional $2.00
  41.         is charged per order to cover these costs. To charge by credit
  42.         card, please complete the following, OR for faster service, call
  43.         FBN BBS (304) 725-1957 and use the Credit Card Order Door.
  44.  
  45.         Full Name as shown on card: ......................................
  46.  
  47.         Type Card (circle):   M/C    Visa    Discover    American Express
  48.  
  49.         CARD Number: .....................................................
  50.  
  51.         Expiration Date: .................................................
  52.  
  53.           I understand that I will be charged $12.00 on the card listed
  54.           above, and agree to pay this charge in accordance with the
  55.           agreement governing the use of such card. 
  56.  
  57.                      _________________________________________
  58.                       Signature                         Date
  59.          
  60. ----------------------------------------------------------------------------
  61.                      YOUR SYSTEM DESCRIPTION AND NOTES
  62.     To help me better provide support, please describe the system on which
  63.     you intend to use this door. Please include BBS Type, fossil type if
  64.     applicable, serial card type, number of nodes, etc. Also, please feel
  65.     free to add any comments or suggestions:________________________________
  66.     ________________________________________________________________________
  67.     ________________________________________________________________________
  68.     ________________________________________________________________________
  69.     ________________________________________________________________________
  70.     ________________________________________________________________________
  71.     ________________________________________________________________________
  72.  
  73.  
  74.                  Thank You for supporting the shareware concept.
  75.