TriMessageScanner ORDER FORM


     Name    ______________________________________________________________

     Address ______________________________________________________________

             ____________________________________________

     City    __________________________ State ______ Zip __________________

     Country __________________________

     Phone   __________________________

     Would you mind if I listed your bbs as using TriMS???  If not please
     complete the following.

     Your BBS Name: __________________________________________


     What BBS Software: _________________________________________


     Modem Speed(s): _________________________________________



     Mail Orders:

     Bill Worley
     19 Kerbaugh Road
     Altoona, PA 16601

     Name you want the software to show as being registered to:

		_____________________________________________


     If you are picking up your KEY please complete the following for a quicker
     logon.

	User Name Desired _______________________________

	Password  ______________________________

	City, State  __________________________________

	Birthdate  ____________________________


     By completing this it will make your initial logon time quicker.  KEY 
     files will be made as soon as I receive the request.   

     If you would like the KEY file delivered please fill out the following:

	My User Name or Number _____________________________________
        
	My Password __________________________________

	Birthdate you used _________________________________

	My City & State are Altoona, Pa 16601

     This will make my logon to deliver your key much easier and it's 
     appreciated.