


                      
                      
                      
                      Wizard Maze 3D Registration Form


        Name__________________________________________________________

        Address_______________________________________________________

        ______________________________________________________________

        City____________________________  State______  Zip ___________

        Voice phone #_________________________________________________

        Data phone #__________________________________________________

        Fidonet Netmail address_______________________________________
        
        Credit card orders may be placed by modem through
        The XT Connection! BBS (703)963-3878 or send this form 
        through Fidonet Netmail to Matthew Hudson @ 1:18/14.4.
        For credit card orders by voice call: (703)964-6160 

        Credit Card #_________________________________________________
        
        _____VISA    _____MasterCard   Expiration Date:_______________

        Card Holders Name:____________________________________________

        Signature:____________________________________________________
        
        Wizard Maze 3D Registration                 $15.00 ___________

        VA residents please add 4.5% sales tax.            ___________

                                                     Total ___________
        
        Registration key information: Please type or print exactly the 
        way it would appear in your WM3D.CFG file!

        SYSOP Name____________________________________________________

        BBS Name______________________________________________________
        
        Send registration key via:  ____ Netmail   ____ Postal Service
        
        Thank you for registering Wizard Maze 3D!
        
        Matthew Hudson
        P.O. Box 287
        Doran, VA 24612
