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Text File  |  1993-04-24  |  1.1 KB  |  34 lines
  1.  
  2.                            Registration Form
  3.                              D & D Poquette
  4.                             6033 N. 37th St.
  5.                        Milwaukee, WI  53209-3662
  6.                          Phone:  (414) 536-5841
  7.  
  8.  
  9.            HAM Station:        _______________________________________
  10.  
  11.            Name:               _______________________________________
  12.  
  13.            Address:            _______________________________________
  14.  
  15.                                _______________________________________
  16.  
  17.            City, State, Zip:   _______________________________________
  18.  
  19.            Country:            _______________________________________
  20.  
  21.            Phone:              _______________________________________  
  22.  
  23.                   ___ NCS                  @ $5.00 USD $________._____
  24.                                            TOTAL ------>________._____
  25.  
  26.            
  27.            All funds must be in US Dollars, Call for UPS COD (USA only),
  28.            Personal and Company Checks Accepted.  All checks must be drawn
  29.            against a US Bank and payable in US Dollars.
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