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Registration Form for ChaosWar                                  -
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Your Name ____________________________________________

Your Street Address __________________________________

Your City/St/Zip _____________________________________

Your Voice Telephone Number __________________________

Your BBS name ________________________________________

Your BBS Telephone Number ____________________________

How many people can simultaneously access ChaosWar on your system?
                                  ____________

Is your BBS private      [ ]Y     [ ]N

Do you charge users
for access to ChaosWar   [ ]Y     [ ]N

$15 US is enclosed as       [ ] Check     [ ] Money Order

In a week I will log on with my real name as given above to
the ChaosWar suppport BBS (+1 414 781 8690) to download my
registered ChaosWar copy               [ ]Y
              -or-
Enclosed is $5 extra, totalling $20, for shipping the
registered ChaosWar copy. Please send it to me on a low
density          [ ]5¬        [ ]3«         inch disk.

Thanks for taking the time to fill this out. Make checks
payable to Rajib K. Mitra and mail to:

     ChaosWar Registration
     3225 Old Lantern Drive
     Brookfield, WI 53005-3014