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  1.                        WhizPad Registration Form
  2.                                             Version 1.00
  3.  
  4.      To register, print this form, fill out the blanks, and include a
  5. cheque or money-order of $10 (Cdn. for Canadian orders, otherwise
  6. American) or more, to:
  7.  
  8.      Patrick Lam
  9.      2780 Honore Beaugrand
  10.      Montreal, Quebec, Canada
  11.      H1L 5Y3
  12.  
  13.      I will personally call and upload the next two major releases of
  14. the WhizPad to your BBS, (North America only) if you create an account
  15. for "Patrick Lam" and write the password in the blank below.  If you
  16. include $20, I will upload the current version, plus the next two
  17. releases, personalised.
  18.  
  19. Real Name:              _______________________________________________
  20. Alias:                  _______________________________________________
  21.  
  22. Street Address:         _______________________________________________
  23. City, Province (State): _______________________________________________
  24. Postal Code (ZIP code): _______________________________________________
  25.  
  26. Please check one:
  27.    _   Canada                          _ United States
  28.    _   Other (specify) ________________________________________________
  29.  
  30. BBS Name:              ________________________________________________
  31. BBS Program + version: ________________________________________________
  32. BBS Phone Number:      ________________________________________________
  33. My password:           ________________________________________________
  34.  
  35.                                                        - Patrick Lam
  36.