MiniBBS Registration Form  (07/12/95)     $ 6.00     Please PRINT or TYPE
    =========================================================================

    Registration Info:

          Sysop *REAL* Name: _____________________________

          BBS Name:          _____________________________

    Optional -- Fill out only if you want MiniBBS registered to your Alias:

              SysOp Alias:   _____________________________


    Mailing Information                      BBS Information
    =========================================================================
                                         |   
    Address:  ________________________   |   BBS Phone: (____) ____ - _______
                                         |  
    City:     ________________________   |   Hours: ___________   BPS: ______
                                         |
    State:    ________________________   |   Software: ______________________
                                         |
    Zip Code: ______________             |   Version: ____   Registered? ____
                                         |
    Phone Number: (____) ____ - ______   |   Nodes: ____   Years Online: ____
                                         |
    =========================================================================

    Where did you get MiniBBS?  _____________________________________________

    =========================================================================

    MiniBBS is now being distributed by the author and by TBRGames. To obtain

     the latest versions of MiniBBS and all TBRGames' Doors, you may contact

           TBRGames BBS @ 812-424-3781   Name: GUEST   Password: GUEST

    =========================================================================


    =========================================================================

                  Mail Check or Money Order (US Funds Only) to:

                                  Tom Mitchell
                             125 N. 4th St.  Apt. B
                               Chandler IN  47610

    =========================================================================