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REGISTER.ALL
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1991-04-04
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2KB
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R E G I S T R A T I O N F O R M G O L D E D
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Print, fill in, and send this form to:
Odinn Sorensen Site Currency: DKK - Danish Kroner
Kajerod Vaenge 33 2:231/77 @ FidoNet
DK-3460 Birkerod 27:1345/118 @ SigNet
Denmark, Europe 800:231/0 @ ZygoNet
Phone +45-4582-1325 [Data/BBS Line]
Qty Amount
___ GoldED Registration ..................................... ________
___ Source Code (extra) ..................................... ________
___ Disk & Handling (extra, only if ordering a disk) ........ ________
___ Currency Conversion (extra, only if not Site Currency) .. ________
Currency type: ____________________ Total ....... ________
Payment method, please tick one:
( ) EuroCheque enclosed. (Please write amount in Danish Kroner).
( ) Bank Cheque enclosed. (Cross the cheque like this: [//]).
( ) Sent to PostGiro 4 51 50 05. (PostGiro Bank Acc# 1199-451-5005).
(Sorry, No Credit Cards Accepted).
Disk format, please tick one:
( ) 5.25" (360k).
( ) 3.5" (720k).
( ) No disk needed.
Where to send the disk:
Name: _____________________________________________________________
Address: _____________________________________________________________
Address: _____________________________________________________________
Address: _____________________________________________________________
The GoldED key only contains your name, not anything else.
Name for your key: ___________________________________________________
The key will be sent by (direct, if possible) netmail upon receipt of
payment. Please state your net address(es) (preferably in FidoNet).
If you are not in FidoNet, please state the telephone number and hours
of your BBS/mail system or (if you are a Point) the Boss system.
Net address/phone : _________________________________________________
Net address/phone : _________________________________________________
Net address/phone : _________________________________________________
Net address/phone : _________________________________________________
Net address/phone : _________________________________________________
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