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Text File  |  1997-03-23  |  2KB  |  59 lines
  1.                      The PCB Bulletin Executive v2.01
  2.           Copyright (c)96,1997 by Practical Computer Services
  3.  
  4.                      R E G I S T R A T I O N    F O R M
  5. ------------------------------------------------------------------------------
  6. 1. Name : [                                                               ]
  7.  
  8. 2. Address Line 1 : [                                                     ]
  9.  
  10. 3. Address Line 2 : [                                                     ]
  11.  
  12. 4. City : [                            ]  State : [   ]  ZIP : [          ]
  13.  
  14. 5. Home phone # [                      ]  Data  # [                       ]
  15.  
  16. 6. BBS Name [                                          ]   # of nodes [   ]
  17.  
  18. 7. Requested Password on The TAO BBS: [                        ]
  19.  
  20. 8. Your Internet E-Mail Address: [                          ]
  21.  
  22.   Remember! Call (609)587-2672 to download your registered version.
  23.   ========================================================================
  24.   CHARGE IT!
  25.  
  26.        Name (as it appears on card) ______________________________________
  27.  
  28.        Expiration Date: ____/_____
  29.  
  30.        Card Number: __________________________________
  31.  
  32.        Signature: ____________________________________ Date: ____________
  33.  
  34. ------------------------------------------------------------------------------
  35.   Qty.       Product & version #                Price Each        Total Price
  36. ------------------------------------------------------------------------------
  37.  [   ]       PCBBE v2.01                        $15.00            $
  38.  
  39.  [   ]       Universal Key Registration         $40.00            $
  40.              (Registers all Universal Key Shareware)
  41.  
  42. ------------------------------------------------------------------------------
  43.                                 6% Sales Tax (NJ Residents only): $
  44.                                Shipping & Handling (Disk orders): $ 2.50
  45.                                                       Total Cost: $
  46.  
  47.  
  48.  Please make check/MO payable to: PRACTICAL COMPUTER SERVICES
  49.  
  50.  Mail this form along with a check or money order to:
  51.  
  52.              Practical Computer Services
  53.              483 Klockner Road
  54.              Hamilton, NJ 08619
  55.  
  56.       VOICE: (609)584-7947                INTERNET: bob.watson@tao.com
  57. SUPPORT BBS: The TAO BBS  (609)587-2672  33,600 Baud  USR v.everything
  58.    WEB SITE: http://www.nerc.com/~pcs/
  59.