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Cream of the Crop 21 (Terry Blount) (October 1996).iso
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asydv204.zip
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ASYLUME.REG
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1996-08-07
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Registration Form For ASYDV204.ZIP
==================================
Registration For THE ARKHAIM ASYLUM: A Chapter Of Ones Mind
DOOR GAME VERSION 2.04
(If someone else is registering WITH you, please EACH fill out a form)
Name : ______________________________ Age: ______ (optional)
Handle: ______________________________
Address: ___________________________________________________________
City : _______________________
State or Province: _______ I-net Address : _____________________________
Zip: _ _ _ _ _ - _ _ _ _ Or _ _ _ -_ _ _ (Canada)
BBS Name: _______________________________ BBS Software: ______________
BBS Phone Number: (_____)______-__________ Max baud rate: _____________
Home Phone Number: (_____)______-__________ More then 1 phone line? [ ] Yes!
I want a The Arkhaim Asylum Reg! ($10) : [ ] Yes!
My total for THIS order is 2 or more, so each is $7! : [ ] Yes!
Subtotal ................................................. : ___________
I want the latest version of The Arkhaim Asylum Door Game sent to me on:
a 1.44 3.5" disk for an additional $5.00 [ ] Yes [ ] No
a 750 5.25" disk for an additional $2.00 [ ] Yes [ ] No
Amount of money enclosed for this order (Canadian Currency!): ___________
Comments / Suggestions :
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Send this form with your Canadian funds check or money order to:
Christian A. Danychuk <--(Make check out to this name!)
1081 Wellington St.
Port Elgin, ON
NOH 2C3