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REGISTER.FRM
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1996-08-26
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2KB
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57 lines
Drakeville Registration Form
-=-=-=-=-=-=-=-=-=-=-=-=-=-=-
Name : __________________________________________________________
E-MAIL : _________________________________
Address : __________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
City : _______________________
Country : ______________________
Province or State ___ Zip _____-____ or ___-___ (Canada)
Home Number (_ _ _) _ _ _ - _ _ _ _
BBS Name : ___________________________________________
BBS Phone Number (_ _ _) _ _ _ - _ _ _ _
Please write any comments or sugestions you might have.
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Send check or money order or cash for 10$ (CANADIEN OR US FUNDS ONLY) to :
Stephane Daigle
559 Fleet Cr.
Bathurst NB
E2A-4H2
Canada
** IMPORTANT **
If it's between September 1st 1996 to April 1997 you can send registration
fee to :
Stephane Daigle
360 Gauvin Rd. apt 405
Dieppe NB
E1A-1M1
Canada
The first adress will always work but the second one should be quicker!