Street Surgeon version 1.0 (c) 1994 Registration Form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Name:       ________________________________

BBS Name:   ________________________________

BBS #:      ________________________________

Home #:     ________________________________

FidoNet:    ________________________________

InterNet:   ________________________________

Method of delivery:

( ) FidoNet CRASH mail
( ) Call BBS and upload it (Make acount under Johnny Martin and SS
    as password) (Not for InterNational people)

Fill this file out, enclose $10, and send it to:

John Martin
2405 Luhring
Midland, MI  48640

Thanks a lot and keep on cutting!