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Text File  |  1992-04-29  |  3KB  |  55 lines
  1.  
  2.       Registration Form for PCB-Deposit v1.95 for PCBoard 14.5a
  3.  
  4. Sysop Name:______________________________________________(Print Clearly Please)
  5. BBS Name:________________________________________________(Print Clearly Please)
  6. BBS Phone:_______________________________________________(Print Clearly Please)
  7. Home Phone:______________________________________________(Print Clearly Please)
  8. Password to Use On BBS:__________________________________(Print Clearly Please)
  9.  
  10. Registration is welcomed by: personal check, or money order, with no charge for
  11. shipping and handling.  You will just need to call the BBS and download your
  12. DEPOSIT.KEY file.
  13.  
  14.                                                    Enclosed $20.00:____________
  15.  
  16. Registration is also welcomed by: VISA, MasterCard, Discover, Diners Club,
  17. Carte Blanche, or JCB cards. For all credit card orders shipping and handling
  18. will be automatically added to the initial registration cost.
  19.  
  20. Enclosed is $22.00 for the Registered Version of PCB-Deposit Door v1.95
  21.  
  22. [] VISA, [] MasterCard, [] Discover, [] Diners Club, [] Carte Blanche, [] JCB
  23.  
  24. Card Number:____________________________________ Expiration Date:_____________ 
  25.            
  26.  
  27. Card Holder's Signature REQUIRED:_____________________________________________ 
  28.                                           
  29.  
  30.  
  31. Shipping Address:_____________________________________________                 
  32.                  _____________________________________________
  33.                  _____________________________________________                 
  34.                  _____________________________________________
  35.                  _____________________________________________                 
  36.                 
  37.                                                    Enclosed $22.00:___________ 
  38.       
  39. Make Checks Payable to:
  40.  
  41. Cam DeBuck Software
  42. 235 East 1300 North
  43. Springville, UT  84663
  44.  
  45. If you have any comments, please let me know:
  46. ______________________________________________________________________________
  47. ______________________________________________________________________________
  48. ______________________________________________________________________________
  49. ______________________________________________________________________________ 
  50.                                                                  
  51.                                                                              
  52. *DO NOT SEND CASH -- Please use a Check or a Money Order *
  53. * If you are Registering outside the U.S. or Canada, please be sure to send
  54. * your Registration Money in U.S. Currency Funds (Money Order in U.S. Funds)
  55.