NEWIES 4.1 REGISTRATION FORM: (Please Print or Type) NAME:_______________________________________________ ADDRESS:____________________________________________ PHONE #:__(_____)____________________________________ BBS NAME:____________________________________________ BBS PHONE #: __(_____)_______________________________ BBS BAUD RATE: 2400 / 9600 / ___________________ YOUR NAME AS YOU WOULD WANT IT TO APPEAR ON NEWIES: FIRST: ___________________________________________ MIDDLE: __________________________________________ LAST: _____________________________________________ WOULD YOU LIKE YOUR REGISTERATION CODE MAILED TO YOU? YES/NO WOULD YOU LIKE TO DOWNLOAD YOUR REGISTERATION CODE? YES / NO IF DOWNLOADING FROM MORONIHAH BBS WHAT ACCOUNT PASSWORD WOULD YOU LIKE: _____________________________________________________________________ IF DOWNLOADING FROM MORONIHAH BBS WHAT IS YOUR BIRTHDATE? ____/____/_____ yr mo day WOULD YOU LIKE YOUR REGISTRATION CODE PUT ON HOLD AT FIDO 1:3657/5? YES/NO WHAT BBS SOFTWARE DO YOU USE? _______________________________________ NOTE: We will use your first, middle, and last name as it appears above as your sign on name. Complete this form and send, along with $5.00 to: The MORONIHAH BBS c/o Brad Hodges 1321 Barry Road Anniston, AL 36206 NOTE: You must call and pick up your KEY file!