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- FFFFFF A X X Please FAX this form to: 800-235-6445
- F A A X X For International Faxes: 770-612-9855
- FFF A A XX Or Mail to: $(system.application)
- F A AAA A X X c\o Pipeline Communications
- F A A X X PO Box 671449
- Marietta, GA 30067 USA
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- Please Do Not Send A Cover Page With This Fax. date: $(system.date)
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- Registration $(system.version)
- XXX:ALSXLSLAAALL
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- Hi $(REGISTER.201), thank you for registering.
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- First Name: $(REGISTER.201) Middle Initial: $(REGISTER.202,1) Last Name: $(REGISTER.203)
- Title: $(REGISTER.205)
- Company Name: $(REGISTER.204)
- Street Address: $(REGISTER.213)
- Apt./Suite #: $(REGISTER.214)
- City: $(REGISTER.215)
- State/Province: $(REGISTER.216,2)
- Zip/Postal Code: $(REGISTER.217,11)
- Country: $(REGISTER.218)
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- Phone Area Code: $(REGISTER.206) Phone Number: $(REGISTER.207) Extension: $(REGISTER.208)
- Fax Area Code: $(REGISTER.209) Fax Number: $(REGISTER.210)
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- Store Purchased: $(REGISTER.219)
- Location: $(REGISTER.220)
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- AOL: $(specials.aol)
- NetGuide: $(specials.netguide)
- WinMag: $(specials.winmag)
- HomePC: $(specials.homepc)
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- XXX:ALSXLSLAAALL
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