TriMeM REGISTRATION FORM ------------------------ Registration of TriMeM ver 2.0 is $10.00 (U.S. Funds Only!). Please enclose your check or money order with this form. Please answer all of the following questions: Name:____________________________________________________________ Address:_________________________________________________________ City:__________________________State:__________Zip:______________ Telephone Number:________________________________________________ Optional Information: What is the name, number, and type of BBS(specialty) You are running? ----------------------------------------------------------------- _________________________________________________________________ Any additional comments: _________________________________________________________________ _________________________________________________________________ Mail To: Jeff Hutchens P.O. box 820 Crescent City, CA 95531 THANK YOU FOR REGISTERING TRIMEM 2.0