
         Registration form for Crazy Larry's Online Art Products
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         All sales are final! By using any CLOA wcCode product, you
         take full responsibility for the use of said products. Any
         damages that occur from the use, or misuse of any products
         whether accidental or coincidental are your responsibility
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         Please print or edit this file legibly, and accurately
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         Your name as entered in wcConfig:  _______________________

         Your BBS  as entered in wcConfig:  _______________________

         Your BBS registration code from wcConfig:  ____-__________

         Your BBS  phone number:  _________________________________

         Your Home phone number:  _________________________________

         Address:  _________________________________  Apt #: ______

         City:  _____________________  State/Province: ____________

         Zip/Postal code: __________________  Country: ____________

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         Select which products would you like to register:

         [ ] PULL DOWN MENUS   wcCode Pull-Down menu system  $15.00
         [ ] POWER LOGON       wcCode Configurable logon     $15.00

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         How would you like to pay for your order?

         [ ] Check or money order (enclosed)

         [ ] Credit Card -
                               Name on Card _______________________  
             [ ] Visa                
             [ ] Master Card    Card Number _____-_____-_____-_____
             [ ] American Ex.   
             [ ] Discover           Expires ___/___

         Include a $1.00 handling fee for all credit card orders.

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         How would you like to receive your registration number(s)?

         [ ] Via internet at address: _____________________________
         [ ] Self Addressed Stamped Evelope (enclosed)
         [ ] Via Crazy Larry's Online Art support BBS  503-357-2710

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           FOR OFFICE       Received _________  Key(s) __________  
           USE ONLY!    Check Number _________    Date __________  
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         Make checks or money orders payable to Larry Massengale Jr
         and send it along with this completed form to:

                         BITWISE COMPUTERS
                         P.O. Box 829
                         Forest Grove, OR
                         97116-0829
