SPITFIRE REGISTRATION & ORDER FORM

DATE______________________________

REMIT TO: BUFFALO CREEK SOFTWARE
ATTN: Mike Woltz
913 - 39th Street
West Des Moines, Iowa 50265

********** U.S. FUNDS ONLY! **********

____Copy(s) SPITFIRE Registration (5 1/4 Disk(s)) $85.00 each Total $_______
____Copy(s) SPITFIRE Registration (3 1/2 Disk(s)) $85.00 each Total $_______

License to:

First Name__________________________________________________

Last Name___________________________________________________

Mailing Address_____________________________________________

City________________________________State_______Zip_________

Voice# (_____)_______-_____________

Data# (_____)_______-_____________

Your BBS Name_______________________________________________

Type of modem & max baud rate_______________________________

Modem initialization string used____________________________

Type of system______________________________________________

Public or private BBS_______________________________________

List my BBS and number in SPITFIRE manual (yes/no)__________

Who recommended SPITFIRE (if anyone)________________________

Where did you obtain SPITFIRE_______________________________

Current SPITFIRE Version No_________________________________


PLEASE COMPLETE ONLY IF REGISTRATION FEE
IS TO BE PAID BY A CREDIT CARD TRANSACTION:

Credit card number:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Type of credit card:________________________________________
(Mastercard or VISA)

Expiration Date:__-__-__

Signature___________________________________________________