                   BLACK JACK REGISTRATION

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 First Name :___________________Last Name :_______________________

    Address :_________________________________APT # :_____________

       City :_______________________State :_______ZIP :___________

 Home Phone :(    )____-________
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 BBS NAME :___________________________BBS Software :______________

 BBS Phone :(    )____-________Fido Net/Node :____:______/________

 Maximum Baud Rate :_________________Modem Type :_________________

 Math CO-PROCESSOR ( )YES  ( )NO   Computer Type :________________
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      There are three ways of receiving your registration.  You
      can choose from US Mail, Remote or via FIDONET.  If you do
      choose REMOTE please fill out the REMOTE REGISTRATION SECTION.
      If you choose mail I will send you your key file plus the
      current door(s) you registerd.

 REMOTE REGISTRATION :   (USA ONLY)
      Please make an account with the following information so
      that I can upload the registration code to you.  Also
      give me a password to use on your system.
          ACCOUNT NAME : DANNY DAVIS
      ACCOUNT PASSWORD :                (PRINT PLEASE)
         ACCOUNT PHONE : 209-497-6722
      ACCOUNT BIRTHDAY : 07/26/65
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    BLACK JACK REGISTRATION : QTY____ x $15.50 = $________________

 CHOOSE ONE BELOW :

 ( ) US MAIL                            $ 3.00 = $_____________S/H
    Please Select a Disk Size :
    ( ) 720k       ( ) 360k
    ( ) 1.2        ( ) 1.44

 ( ) REMOTE OR FIDONET (USA ONLY)       $ 2.00 = $_____________L/D

 CA RESIDENT add SALES TAX                       $________________

     Disk with all the latest doors    ADD $1.00 $________________

  TOTAL DUE (US FUNDS ONLY)                      $________________
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 Send Check or Money Order to :
      Danny Davis
      2103 N. Arthur
      Fresno, Ca.  93705
        CHECKS WILL HOLD UP THE ORDER TILL THEY CLEAR THE BANK

  
                   SPECIAL REGISTRATION OFFER

     If you register multiple doors you may take advantage of
     the special pricing shown below.  See DOOR.TXT file for
     more information on the other doors.

     
     Select The Doors You Wish To Register :
     ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
     ( ) Hang-Man             ( ) Thirteen
     ( ) Yahtzee              ( ) Match 15
     ( ) Word Scramble        ( ) Black Jack
     ( ) Solitaire            ( ) Video Poker
     ( ) Tuts Revenge         ( ) Draw Poker
     ( ) Four Leaf Clover     ( ) Seven Towers
     ( ) Solitaire Concentration

     QTY = Number of Doors Checked

                   2 - 4 Doors
                             QTY____ x $14.50 = $ ________________

                   5 - 8 Doors
                             QTY____ x $12.50 = $ ________________

                  All 13 Doors
                             QTY____ x $10.00 = $ ________________

     ( ) US MAIL              ADD      $ 3.00 = $ _____________S/H
         Please Select a Disk Size :
         ( ) 720k       ( ) 360k
         ( ) 1.2        ( ) 1.44

     ( ) REMOTE or FIDONET    ADD      $ 2.00 = $ _____________L/D

     CA residents add sales tax               + $ ________________

  Disk with all the latest doors    ADD $1.00 = $_________________

                   Total US FUNDS DUE         = $ ________________
