Registration Form For Purge
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               Your Full Name ________________________________________

               Street Address ________________________________________

             City, State, Zip ________________________________________

           Voice Phone Number ________________________________________
               (Optional)
             Name of Your BBS ________________________________________

             BBS Phone Number ________________________________________

         Comments/Suggestions ________________________________________

         _____________________________________________________________

         _____________________________________________________________

         _____________________________________________________________

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         Cost for registration is $20.00  Please make checks payable
         to Ray Novino and mail to:

                                   Ray Novino
                                   PO Box 0941
                                   Lansdowne, PA 19050


         We also Accept Visa, Master Card, Discover, and Dinners Club

         Credit Card Number __________________________________________

            Expiration Date ________________________

   Signature of Card Holder __________________________________________