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Text File  |  1994-07-27  |  2KB  |  51 lines
  1.  
  2.                  Dragon's ¥en
  3.                -=-=-=-=-=-=-=-=
  4.                  VERSION 4.2b             SEND TO:
  5.                Registration Form          Matthew Elzer
  6.                _________________          639 Reis Ave.
  7.                  PLEASE PRINT!            Evansville, In 47711
  8.  
  9.  Birth Date_____________                                     
  10.                                  
  11.  Password you would like to logon my BBS with?_______________
  12.                                   
  13.  Your FIRST Name<NO Aliases>_________________________________
  14.                                   
  15.  Your LAST Name______________________________________________
  16.  
  17.  Your Street Address___________________________________________
  18.  
  19.  Your City, State and ZIP code____________________________________________
  20.  
  21.  Your voice phone # (_____)__________________________
  22.  
  23.  Your BBS phone # (_____)____________________________
  24.  
  25.  The NAME of your BBS?________________________________________
  26.  
  27.  Type of BBS software that you are running?_______________________________
  28.  
  29.  Version of your BBS software?______________
  30.  
  31.  Number of Nodes?______________
  32.  
  33.  You modem speed?______________  # of years your BBS in service?____________
  34.  
  35.  How did you get this program? PLEASE be specific! Phone #'s if possible.
  36.  
  37.  ________________________________________________________________________
  38.  
  39.  ________________________________________________________________________
  40.  
  41.  ________________________________________________________________________
  42.  
  43.  
  44.          [ ] Registration fee of $15.00 enclosed 
  45.          I can call your BBS in 72 Hours and
  46.          pick up my Reg.Key file that is
  47.          especially designed for MY BBS!
  48.      
  49.      MAKE CHECKS AND MONEY ORDERS PAYABLE TO: Matthew Elzer
  50.  
  51.