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ORDER.FRM
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1996-07-30
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3KB
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98 lines
Registration Form for Primal Chaos 2.00
=-------------------------------------------=
** SysOp Information **
Name : ______________________________ Age: ___
Address: ___________________________________________________________
City : _______________________
State or Province: ___
Zip: _____ - ____
** Bulletin Board Information **
BBS Name: ___________________________ BBS Software : _________________
BBS Phone Number: (___)____-_________ Max baud rate: ______
Home Phone Number: (___)____-________
** Registering Information **
Please check only one...
Registering Primal Chaos for $15 U.S. Dollars : [ ] Yes!
Registering Battle of The Arts for $15 U.S. Dollars: [ ] Yes!
or
Registering both Primal Chaos & Battle of The Arts
for only the fee of $25 U.S. Dollars : [ ] Yes!
** Ways to Receive Your Registration Code(s) **
** Receiving by mail: Yes! [ ]
I want the newest version of the doors on a (720K)
3.5" disk for an additional $5.00 [ ] Yes [ ] No
Otherwise Your Registration Code(s) will be sent on a Piece of
Paper in the Mail to You. I will try to get you your Reg.
Code(s) as soon as I can.
Name __________________________ (This is how your name will appear
(Minimum of 5 characters) in the door after registration.
(Maximum of 35 characters) Please Print Neatly.)
BBS __________________________ (This is how your BBS name will appear
(Minimum of 5 characters) in the door after registration.
(Maximum of 35 characters) Please Print Neatly.)
** Calling the Support Board: Yes! [ ]
I would like to call the Support Board and receive my registration
code(s) online. Please refer to the "ONLINE.DOC" to see how this
works.
Name : _______________________________ (Print Neatly)
(Minimum of 5 characters - Maximum of 36 characters)
BBS : _______________________________ (Print Neatly)
(Minimum of 5 characters - Maximum of 36 characters)
Password: _______________________________ (Print Neatly - Max 18 Char)
** Amount of money inclosed for this order (U.S Currency ONLY) : ____$
Comments about the game (What should be added for future versions):
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Send this form with your U.S. funds check or money order to:
Robert Colozza (Make check out to this name)
325 Crest Drive
Jefferson City, MO 65109