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              R E G I S T R A T I O N   F O R M  -  M A X ! B B S
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        ( ) Enclosed is _____ x $25.00 U.S. (or eq.) (TOTAL US$  ___________)
            for (1/2 copies) of the latest registered version of MAX!BBS.

        ( ) Enclosed is _____ x $20.00 U.S. (or eq.) (TOTAL US$  ___________)
            for ____ copies (3 or more) of the latest registered version
            of MAX!BBS.


        NAME: _________________________________________________________

        MAILING ADDRESS: ______________________________________________

        CITY: _______________________ STATE: ______ ZIP: ______________

        PHONE: (______)______-________    BIRTHDATE: ____/____/________

        FROM WHICH BBS DID YOU GET YOUR EVALUATION COPY?
        NAME BBS: ____________________________________________________


                     MAIL CONTRIBUTION AND COMPLETED FORM TO:

                                   Max de Jong
                                   P.O.Box 2160
                                3000 CD Rotterdam
                                 The Netherlands
                                      -.-
                               Fido net 2:512/16.5
                                      -.-
                         PLEASE SEND CASH OR CHECK ONLY!
                         ALLOW 4 TO 6 WEEKS FOR DELIVERY
                                      -.-
        * - ADD US$10.00 (or eq.) PER COPY FOR OVERSEAS HANDLING/SHIPPING
        * - Comments and suggestions are welcome.
            Please attach to this form or write below.

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