DBq REGISTRATION Form

TO:   Harvey Parisien
      Box 323 Station A,
      Kingston, Ontario, Canada K7M 6R2

      FIDONET 1:249/114

Your DBq license entitles you to use all FUTURE UPDATES FREE.

Please find enclosed my registration fee of $15.00us

...per installation by [ ] cash, [ ] check, [ ] money order in US funds.

        Date: _____/_____/_____ (mm/dd/yy)        (Ontario orders add PST)

Organization: ____________________________________________ (if applicable)

  Users Name: ____________________________________________

Mail Address: ____________________________________________

 City, State: __________________________________(________)

 Voice Phone: ____________________________________________

Data Phone -or- Fido Address:   __________________________

CURRENT DBq VERSION:    _______________________________



      Yours truly;




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