Registration form for MaxBlue (c) 1995 by Leon Makkink
Release Version 1.0

Name       :...................................

Adress     :...................................

City       :...................................

Zip Code   :...................................

Country    :...................................

Tel. BBS   :...................................

Tel. Voice :...................................

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Systemname (Name of the BBS)                  :........................

Packetname (How you want to call the packets) :........................

Sysopname  (Your name as used on the BBS)     :........................

(Exactly as you have defined them with the 'SetupDoor' program)
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Where did you get MaxBlue?

......................................................................


In what way would you like to receive your registration number?

.......................................................................


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Send your registration form to:

W. van Dijk
Roemer Visscherstraat 115
2533 VE The Hague
The Netherlands

Or to:

C. de Bruin
Steenzicht 187
2543 AD The Hague
The Netherlands
	

The price of MaxBlue will be US$ 20

You can pay by:

Sending a Eurocheque
A Postal Money Order


Bank: VSB bank The Hague, the Netherlands, Account 88.13.01.833, "W. van Dijk"

Thank you for your registration!
Please allow up to three weeks for delivery.

Willem & Cor