Registration Form for PCB-Net v5.4 for PCBoard 15.0

Sysop Name:______________________________________________(Print Clearly Please)
BBS Name  :______________________________________________(Print Clearly Please)
BBS Phone :______________________________________________(Print Clearly Please)
Home Phone:______________________________________________(Print Clearly Please)

Password to Use On BBS:__________________________________(Print Clearly Please)

Registration is welcomed by: personal check, or money order, with no charge for
shipping and handling.  You will just need to call the BBS and download your
PCBNET.KEY file (if using a credit card, $12.00 will be charged).


                                                   Enclosed $10.00:____________

Registration is also welcomed by: VISA, MasterCard, Diners Club,Carte Blanche,
or JCB cards. For all credit card orders shipping and handling will be
automatically added to the initial registration cost.

Enclosed is $12.00 for the Registered Version of PCB-Net v5.4

[] VISA, [] MasterCard, [] Diners Club, [] Carte Blanche, [] JCB

Card Number:____________________________________ Expiration Date:_____________ 
           

Card Holder's Signature REQUIRED:_____________________________________________ 
                                          


Shipping Address:_____________________________________________                 
                 _____________________________________________
                 _____________________________________________                 
                 _____________________________________________
                 _____________________________________________                 
                
                                                   Enclosed $12.00:___________
      
Make Checks Payable to:

Cam DeBuck Software
235 East 1300 North
Springville, UT  84663

If you have any comments, please let me know:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________ 
                                                                 
                                                                             
*DO NOT SEND CASH -- Please use a Check or a Money Order *
* If you are Registering outside the U.S. or Canada, please be sure to send
* your Registration Money in U.S. Currency Funds (Money Order in U.S. Funds)

For Technical help call (801)489-4878
For BBS Support/Ordering call (801)489-3558 [HST 1440]

We will be on vacation from April 8th, 1993 through April 21st, 1993.  Please
be patient while we are away.