Shuttle to BBS Registration Form --------------------------------------- PLEASE PRINT CLEARLY NAME : _____________________________________________________ DOB : (____/____/19_____) ADDRESS : _______ _________________________________________ Apt. # Street ____________________________ _____ _______-_____ City State Zip REGISTRANTS SIGNATURE : ___________________________________________________ REGISTERED TO: __________________________________________________ PHONE : Voice (_____)_______-_________ Data (_____)_______-_________ Fax (_____)________-________ HOURS CAN BE REACHED: ___________________ PLEASE SPECIFY TIME ZONE. ***************************************************************** ALL PRODUCT PAYMENTS MUST BE IN UNITED STATES DOLLARS. EITHER IN THE FORM OF A CHECK OR MONEY ORDER. ALL FOREIGN CUSTOMERS CALL ONE OF OUR SUPPORT SYSTEMS (SEE DOCS FOR LIST) ENTER A COMMENT TO THE SYSOP FOR MORE INFORMATION ON FOREIGN COPY. BBS LANGUAGE IS AMERICAN ENGLISH. ***************************************************************** Cost : UNITED STATES: StoBBS................5.¬.(___)......@ $10.60 EACH+SHP. StoBBS................3.«.(___)......@ $12.50 EACH+SHP. ".........."..BOTH MEDIUMS..........@ $15.20 EACH+SHP. Upgrade...............5.¬.(___)......@ $3.75 EACH+SHP. Upgrade...............3.«.(___)......@ $5.00 EACH+SHP. Canadian: StoBBS................5.¬.(___)......@ $15.00 EACH+SHP StoBBS................3.«.(___)......@ $16.00 EACH+SHP ".........."..BOTH MEDIUMS..........@ $19.00 EACH+SHP Upgrade.............5.¬.(___)......@ $4.75 EACH+SHP. Upgrade.............3.«.(___)......@ $6.00 EACH+SHP. Foreign: StoBBS................5.¬.(___)......@ $20.75 EACH+SHP StoBBS................3.«.(___)......@ $23.85 EACH+SHP ".........."..BOTH MEDIUMS..........@ $26.93 EACH+SHP Upgrade...............5.¬.(___)......@ $5.75 EACH+SHP. Upgrade...............3.«.(___)......@ $7.00 EACH+SHP. Shipment: U.S. & CANADA..SNAIL..MAIL...........@ $ 3.00 * EACH Foreign Shipment Cost.....(___)......@ $ 5.00 * EACH Included : Payment of $ _________ Money Order (___) Check (___) %% NOTE %% Please address checks or money orders to Steven P. Lewkowicz MAIL TO: Stephan Lewkowicz :*!* METHOD TIMESTUDY COORD Bridgeport Machines Incorporated P.O. Box 32 Bridgeport, CT 06601