
                       Registration form for Xtruder
                       ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    The following personal data will only be seen and stored by the author
    of Xtruder, Martin Wulffeld, and will not be made accesible to anyone
    else.

    If you have printed this PLEASE WRITE LEGIBLY!


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                    Full Name:______________________________________

                 Full address:______________________________________

                              ______________________________________

                              ______________________________________

                              ______________________________________

                              ______________________________________


                 Phone number:+___-(____)-_________________

              Fidonet address:____:____/____.____

               Amynet address:____:____/____.____

              Are you a sysop:________ BBS:_________________________

      Complaints, wishes etc.:______________________________________

                              ______________________________________

                              ______________________________________

     Tick the following:

             I pay cash:__    I pay via bank transfer:__

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    You can send the money to me by mail at the address below, but keep
    in mind that it is at your own risk. I cannot in any way be held
    responsible for lost letters but if you do just wrap a piece of
    paper around the cash so noone can see what's inside the envelope!

      Martin Wulffeld,
      Fredensvej 14,
      4720 Praestoe,
      Denmark

    Or you can transfer the money to my bank:

      Praestoe Afdeling,
      Adelgade 76,
      4720 Praestoe,
      Denmark

      Name: Martin Wulffeld

      Reg. number:    0047
      Account number: 4482-600-846
