Registration Form For AIS PPEs
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[ ] CallUp   -- Callback Verification PPE For PCBoard...... $ 10.00
[ ] Msg-Pack -- QWK Interface PPE For PCBoard.............. $ 10.00


TOTAL ENCLOSED............................................. $_______

Registrations can be sent to:

                         Access! Information Services
                             C/O James Nerlinger
                                P.O. Box 58505
                         Cincinnati, Ohio 45258-0505
                                (513) 244-2255

Please make checks payable to James Nerlinger.

NAME EXACTLY AS YOU WANT IT TO APPEAR (CASE SENSITIVE):

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NAME        :_____________________________________________________

ADDRESS     :_____________________________________________________

            :_____________________________________________________

CITY        :_____________________________________________________

STATE       :_____________________________________________________

ZIP CODE    :_____________________________________________________

PHONE#      :_____________________________________________________

NET ADDRESS :_____________________________________________________

Are you registered on my BBS?  ( Y / N )

SUGGESTIONS :_____________________________________________________

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All registration numbers will be sent to you via EMAIL.  If you do not have
an email address, one will be sent via US Postal.  If you have not heard 
anything from me within 7 days call the BBS and let me know -- your 
registration may have been lost in the mail.