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Text File  |  1991-07-06  |  1.6 KB  |  43 lines
  1.                               SeaMine Registration Form
  2.                               ------- ------------ ----
  3.  
  4.           Please print:
  5.  
  6.           Name  ______________________________________________________
  7.           BBS Name  __________________________________________________
  8.           Address  ___________________________________________________
  9.           City  ______________________________________________________
  10.           State  __________________  Zip code  _______________________
  11.  
  12.           Voice Phone #  (_____)______________________________________
  13.           BBS Phone #    (_____)______________________________________
  14.  
  15.                BBS Software:
  16.                (must check one)
  17.                     []   QBBS
  18.                     []   WWIV
  19.                     []   Other:  _____________________________________
  20.  
  21.           BBS Software Version  ______________________________________
  22.  
  23.           If you subscribe to Fidonet, WWIVLink, or WWIVnet, please
  24.           check which applies and include node identification:
  25.  
  26.                []   Fidonet
  27.                []   WWIVLink
  28.                []   WWIVnet
  29.  
  30.           Network Address  ___________________________________________
  31.  
  32.  
  33.           Disk type:              5.25":     []  360k    []  1.2 Meg
  34.           (please check one)      3.5":      []  720k    []  1.44 Meg
  35.  
  36.           Please send a check for $20 (shipping and handling included)
  37.           payable to:
  38.  
  39.                          Chris Allen
  40.                          P.O. Box 19765
  41.                          Raleigh, NC 27619
  42.  
  43.