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             Registration Form For Programs By Mullins Software
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Real name: ____________________________________________________

"Registered To" Name: _________________________________________

Address: ______________________________________________________

City: _________________________________________________________

State or Province: ____________________________________________

IDioTicNeT: _________________ SpeakEasy Net: __________________

Zip: ___________________

BBS Name: _____________________________________________________

BBS Number: (_______) _______-__________

Internet address: _____________________________________________

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Put a 'X' in the '[ ]' beside the option you want..

Which Mullins Software program do you want to register:

    [ ] 1. I want to register The Wall! ($5)
    [ ] 2. I want to register Random Lord Looks! ($3)
    [ ] 3. I want to register Lord Looks (LORD IGM) ($5)

How do you want to get your key:

   [ ] 1. I want to call your BBS and get my key.  (See BBS info at bottom)

   [ ] 2. I want my key Internet emailed to me (must specify address above).

   [ ] 3. For an addtional $1, I want my code crash netmailed to me via
          SpeakEasy Network. (specify address above) (USA Only!)

   [ ] 5. I want my key mailed to me (Snail Mail).

Other Stuff:

    [ ] 1. I want the latest version of every Mullins Software sent to me on
           a 1.44 3.5" disk for an additional $5.00!

    [ ] 2. I lost my code! - Please send me a new one snail mail for $1!
           NOTE: You can use "How do you want to get your key" option
           #'s 1 or 2, and I'll give a new key at no charge.


  Amount of money enclosed for this order (U.S. Currency!) : $_______



Comments / Suggestions :

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Send this form with your U.S. funds check or money order to the address below.

Make the check or money order out to: Ed Mullins

Snail Mail: Ed Mullins
            Mullins Software
            HC 69 Box 865
            Park Hill, OK  74451-9629

Bulletin Board:  Name: The Gamer's Realm
                 Number: (918) 457-3453
                 Hours: 24 hours/7 days
                 Baud: 2400 - 14,000 Baud

Internet: ed.mullins@origins.bbs.uoknor.edu

SpeakEasy Network: 18:1918/0

IdioticNet: 30:110/100

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Date Recieved: ____/____/____   Postmarked: ____/____/____