--------------------- Multi-Talk Registration -----------------------

Name
----

Surname___________________________ Given Name________________________


Address
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Street Address_______________________________________________________

City______________________________ Prov./State_______________________

Country___________________________ Postal/ZipCode____________________

Internet Address__________________ FIDONet Address___________________

Other E-mail Addresses (please specify)______________________________

_____________________________________________________________________


Bulletin Board System you run
-----------------------------

BBS Name__________________________ Phone Number______________________

Number of lines___________________ Baud Rate(s)______________________

Computers Supported__________________________________________________

BBS Software_________________________________________________________

Physical Address, if different from above____________________________

_____________________________________________________________________

FIDO Address, if different from above________________________________


Version
-------

Version you have now_________________________________________________

Please mark with "*".  Version you are registraring:
[ ] 1. 2 users ............$19US
[ ] 2. 4 users ............$39US
[ ] 3. unlimited versions .$99US


Payment
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Method of payment:
[ ] Money order
[ ] Personal cheque, please allow 3-4 weeks for clearance.

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