                     TriList Registration Form
                              Mail to:

                           Robert Meier
                           P.O. Box 27901
                           Greenacres
                           6057
                           Port Elizabeth
                           Republic of South Africa

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| Name   :________________________________                                   |
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| Address:________________________________                                   |
|                                                                            |
|        :________________________________                                   |
|                                                                            |
|        :________________________________                                   |
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|        :________________________________     Total Enclosed    $_____.___  |
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| What is the name of your BBS exactly as it is in your configuration?       |
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| BBS Name : ______________________________________________________________  |
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| What is your name, exactly as it is in your configuration?                 |
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| Sysop Name : ____________________________________________________________  |
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| Where did you get TriList                                                  |
|                                                                            |
| [ ] Directly from me                                                       |
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| [ ] BBS                   Name __________________________________________  |
|                           Their phone number: (_____)____-_________        |
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| [ ] Internet              Site __________________________________________  |
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| [ ] Friend                Name __________________________________________  |
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| [ ] Other                 _______________________________________________  |
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