REGISTRATION FORM ÄÄÄ Another Brick In The Wall v1.1 ÄÄÄÄÄÄÄÄÄÄÄÄÄÄÄÄÄÄÄÄÄÄÄÄÄ Name :___________________________________________________ Address :___________________________________________________ City/State :___________________________________________________ ZIP :___________________________________________________ Country :___________________________________________________ BBS Name :___________________________________________________ BBS Number :___________________________________________________ FidoNet Node # :___________________________________________________ Register Wall to :___________________________________________________ [Sysop or BBS Name] Optional: From where did you originally download The Wall? ________________________________________________ [ ] My BBS is a member of FidoNet; please send me my registration key at the node number listed above. [ ] I will call Temples of Syrinx, 908/914-9807, and download my registration key. Indicate a password below if you do not already have an account on Syrinx and wish to have one premade based on the above information. PASSWORD: _________________ Registration cost: $5.00US. Send payment--check, cash or money order TO: Scott Stuart 832 Ship Avenue Beachwood, NJ 08722 Thank you for your support!