QWKNET v1.2                                      REGISTRATION FORM
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          Send to: Keith Yox, 7272 Rawlins Square, Indianapolis, IN  46260
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         Registration ................................. @ $5 ea $________

         Check or money order payments accepted. Please do not send cash.
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        Name     ___________________________________________________________

        Company  ___________________________________________________________

        Address  ___________________________________________________________

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        Comments __________________________________________________________
               
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        BBS name ________________________________Software type_____________

        BBS phone__________________________________________________________


          
                              Thank you for registering!