Impulse Registration Form
-------------------------

Prices: $20 United States
	$40 Canada/British Columbia
	$50 Other Countries

NOTE: If you live in another country and have American funds, the same price
      for the coutry in question currency still applies.


Sysop Name: ___________________

Sysop Real Name: __________________

Sysop's Email Address: __________________
(leave blank if none)

Sysop's Phone Number: (___)___-____

BBS Name: ____________________

BBS Phone Number: (___)___-____

Sysop's Address: _________________________
		 _________________________
		 _________________________

Mother's Maiden Name: ___________________
(for reg losses only)

Will the BBS be run from YOUR Computer?  If not, who's?

:______________________________________________________


Current BBS Specifications

:______________________________________________________
:______________________________________________________
:______________________________________________________
:______________________________________________________


What Version of Impulse do you have now? ______________

Would you be interested in carrying "viNNet"? yes / no

Would you be interested in making utilities to further the popularity
of Impulse BBS? yes / no

Would you actively participate in the beta testing stages of Impulse?
yes / no

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IN ORDER TO RECEIVE YOUR REGISTRATION NUMBER, I MUST HAVE THE ABOVE
INFORMATION.  SOMETIMES REGISTRATIONS GET BACKED UP, SO FOR FAST AND
PROMPT DELIVERY, EMAIL NIVENH@A.CRL.COM OR GET YOUR BUTT ON TERMITE
TERRACE AND BE SURE TO INCLUDE WHAT YOUR AFTER IN THE NEW-USER EMAIL.

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