THDUTL Registration Form      Mail to:

                          H. D. Holland
                          2911 Chestnut Grove Dr.
                          Austell, Ga. 30001-000

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| Name:___________________________________[ ] THDUTL Registration $25.00US ea|
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| Address:________________________________                                   |
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| City:___________________ State:_________                                   |
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| Zip Code:_______________ Zip+4:_________                                   |
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| Make checks payable to: H. D. Holland        Total Enclosed    $_____.___  |
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| What is the name of your BBS?                                              |
|                           Name __________________________________________  |
|                           Phone number:       (_____)____-_________        |
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| Where did you get THDUTL1.ZIP                                              |
| [] Local BBS              Name __________________________________________  |
|                           Their phone number: (_____)____-_________        |
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|                           [] Other ______________________________________  |
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| [] Directly from me                                                        |
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| [] Friend                 Name __________________________________________  |
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| [] Shareware outlet house Name __________________________________________  |
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