                     Registration Form For LIFE115+.ZIP
                     ==================================

       Registration For For LORD LIFE: The best IGM money can buy!
Note:  Registration is based on your NAME...so that is the MOST
     IMPORTANT thing to get EXACTLY right.

Name  : ______________________________     Age: ___  (optional)
Handle: ______________________________
Address: ___________________________________________________________
City : _______________________
State or Province: ___     FIDO Address : _____________ (optional)
Zip: _ _ _ _ _ - _ _ _ _    Or Postal code _ _ _ -_ _ _ (Canada)

BBS Name: ___________________________    BBS Software: _________________
BBS Phone Number: (___)____-_______      Max baud rate: ______
Home Phone Number: (___)____-______      More then one phone line? [ ] Yes!


  I want a LORD LIFE Registration! ($10)               :   [ ] 

-----------------------------
How would you like to recieve your registration key?
(If you do not mind which way...rank the options from 1..4)
(1 being first choice...if all else fails normal post will be used)

*****BEST OPTION*****
  By E-Mail               [ ]  email address:______________________ 
*********************  

  Message on Arctic Era   [ ]  your name on the bbs:_______________
  (604)852-1447

  With a call to your BBS [ ]  bbs phone# (if different from above)
    (for convienience          my username____________________
     please open my acct       my password____________________
     for this option)          my birthdate_March_03_,_1973___
  
  By normal mail :(       [ ]  give address if different from above


Comments / Suggestions :

________________________________________________________________________
Send this form with your cheque or money order to:

TREVOR KOOY  <--(Make cheque out to this name!)
c/o Shawna Fountain
Arctic Era BBS
34645 Davie Court
Abbotsford, BC, 
CANADA
V2S 6G3

