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Text File  |  1994-08-14  |  4KB  |  76 lines
  1.                             Registration Form
  2.               Please support shareware by making your payment.
  3.           Remit To: Robert Neal, 317 Hickory, Romeoville, IL  60441
  4. --------------------------------------------------------------------------
  5. ____PROGRAM NAME_________________________________   __PRICE__  __AMOUNT__
  6. [ ]  BBS Bowling Solitaire v1.3                        $14.95   ________
  7. [ ]  Card Sharks BBS Door v6.0                         $14.95   ________
  8. [ ]  CD ROM Duplicate File Analyzer v1.3               $ 9.95   ________
  9. [ ]  CD ROM File Date Analyzer v1.0                    $ 9.95   ________
  10. [ ]  DaLabeler v4.8                                    $14.95   ________
  11. [ ]  DizIt v3.5                                        $11.95   ________
  12. [ ]  DizIt PRO v1.0                                    $19.95   ________
  13. [ ]  Links Country Club Golf BBS Door v4.0             $14.95   ________
  14. [ ]  PCBoard User Ratio Monitor v1.6                   $14.95   ________
  15. [ ]  Z-Wordz BBS Door v2.2                             $14.95   ________
  16.  
  17. [ ]  Current version of programs selected on disk      $ 5.00   ________
  18.         Disk size: [ ] 5.25"-High Density   [ ] 3.5"
  19.  
  20. LESS: Volume Discount/# programs ordered (min 2) ____ @ $3.00   ________
  21.         A 20%+ discount for each program ordered             ___________
  22.  
  23.                                                 TOTAL          $
  24.                                                                 ========
  25. Please indicate method of receiving your registration key:
  26.         [ ] - via private message on support BBS (815) 886-9381
  27.         [ ] - via US Mail
  28.         [ ] - via Internet E-Mail
  29.                 Internet E-Mail Address:  _______________________________
  30. ----------------------------------------------------------------------------
  31. ** Payment by Check (US Bank or branch), Money Order or Credit Card Only **
  32.  
  33. Complete if paying by credit card (Visa/Mastercard only):
  34.  
  35. [ ]-Visa        CARD #: _______________________________  EXP DATE: ___/___
  36. [ ]-MasterCard
  37.                 SIGNATURE:  ____________________________________
  38.  
  39. Use your Visa/MasterCard to register online - simply call the support
  40. BBS at (815) 886-3233 or (815) 886-9381, type CHARGE at main menu prompt.
  41. Or you can FAX your order in to (815) 886-9388.
  42. -----------------------------------------------------------------------------
  43.  
  44.    Name: _________________________________
  45.    
  46. Address: _________________________________
  47.  
  48.          _________________________________
  49.          
  50. BBS Name to enter in registration (30 char max)          Phone number
  51.  
  52.  _______________________________________            (    ) _____ - ________  
  53.  
  54. Baud Supported: _______              BBS software used: ___________________    
  55. ---------------------------------------------------------------------------
  56. Fold at the page break below with the printing facing out.  Then fold
  57. letter style, exposing the mailing address and hiding your information.
  58. If necessary, staple check to the mailer, then staple or tape sides and top.
  59.  
  60. _________________________________                                     Place
  61.  
  62. _________________________________                                     Stamp
  63.  
  64. _________________________________                                     Here
  65.  
  66.  
  67.  
  68.  
  69.  
  70.                                          Robert Neal         
  71.                                          317 Hickory         
  72.                                          Romeoville, IL  60441    U.S.A.
  73.  
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