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Text File  |  1992-03-02  |  4.6 KB  |  61 lines
  1.  ___________________________________________________________________________
  2. |                                                                           |
  3. |                     Ten-In-A-Row Registration Form                        |
  4. |___________________________________________________________________________|
  5. |                                                                           |
  6. |                        (Please Print Neatly)                              |
  7. |                                                                           |
  8. | Your Name _______________________________________________________________ |
  9. |                                                                           |
  10. | Street Address __________________________________________________________ |
  11. |                                                                           |
  12. | City ___________________  State _________  Zip Code _____________________ |
  13. |                                                                           |
  14. | Your Voice Phone Number (______) _____________ - ________________________ |
  15. |                                                                           |
  16. | BBS Name ________________________________________________________________ |
  17. |                                                                           |
  18. | Sysop Name ______________________________________________________________ |
  19. |                                                                           |
  20. | BBS Phone Number ________________________________________________________ |
  21. |                                                                           |
  22. | BBS Max Baud ____________________________________________________________ |
  23. |                                                                           |
  24. | FIDONET Number (If Applicable) __________________________________________ |
  25. |                                                                           |
  26. | Comments / Suggestions __________________________________________________ |
  27. |                                                                           |
  28. | _________________________________________________________________________ |
  29. |                                                                           |
  30. | _________________________________________________________________________ |
  31. |                                                                           |
  32. |                                                                           |
  33. |                        Registration Costs:                                |
  34. |                  (Please Check Applicable Boxes)                          |
  35. |                                                                           |
  36. |      [ ]  Basic Registration (Includes Shipping) ....... $15.00           |
  37. |      [ ]  Upload To BBS (Same Day Shipping) ............ $02.00           |
  38. |      [ ]  Ship On 3 1/2 Low Density Diskette ........... $01.00           |
  39. |      [ ]  Ship On 5 1/4 Low Density Diskette ........... -FREE-           |
  40. |                                                         +======+          |
  41. |                                            Grand Total  | $    |          |
  42. |                                                         +======+          |
  43. |                                                                           |
  44. |      Upon receiving your check, the registration key (TENINARO.KEY) will  |
  45. |  be either mailed or uploaded immediately. If uploaded, please create an  |
  46. |  account with the following information:                                  |
  47. |                                                                           |
  48. | User Name : David Mitchell      Password : PCREG     Phone : 313-464-1470 |
  49. |                                                                           |
  50. |             Please make Checks Payable to : DAVID MITCHELL                |
  51. |                                                                           |
  52. |       After form is completely filled out, mail the form and check to:    |
  53. |                                                                           |
  54. |                         Player's Choice Software                          |
  55. |                            c/o Dave Mitchell                              |
  56. |                            36205 6 Mile Road                              |
  57. |                            Livonia, MI 48152                              |
  58. |                                                                           |
  59. |___________________________________________________________________________|
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