


                       EZPEEK ORDER FORM



             Remit to: Mark Hanson                 
                       PO Box 10154
                       Rochester, NY 14610-0154
                       USA



                Price: $15



      Send product to:


                 Name: __________________________________________________


              Address: __________________________________________________
       

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    Registration Name: __________________________________________________


      FidoNet Address: __________________________________________________

    The Registration Name may be your name, BBS name, or a combination.
    Your unique serial number will be based on the Registation Name.

    If a FidoNet address is suppplied, your serial number will be
    netmailed to you at that address.

    Payments from outside of the United States must be in the form of
    one of the following:

            - US currency

            - An American Express money order payable in US currency

            - An international postal money order payable in US currency

            - A check drawn on a US bank payable in US currency

