xxo Registerform

Please fill out this form and send it to:

Dirk Schulze
Spronerstr. 1
06847 Dessau-Mosigkau
Germany


or via eMail oder Fax to:
Fax:	0049 340 517073
eMail:	moh.eyes@t-online.de

If you want to get the  freeswitching number by mail please
send with an on you adressed envelope and 2,- US$ for the stamps.

!!  Don't forget to write the register number 
(on the register dialog in the game) on this form . Without this 
number I can't generate a freeswitching code for you . 

With tis formular I want to register xxo  for  6,- US$ or  10,- DM . 

Name :____________________________________	Date:______________

Adress:___________________________________

__________________________________________

__________________________________________

__________________________________________
If existing:
	eMail:____________________________________

	Fax: _____________________________________

Register nummer(In the register dialog in the game)


_________________________________-DS01

[  ]  I enclose the  money  cash in this envelope .
	(Preferably 6,- US$ or 10,- DM , but the equivalent amount
	in any other currency (only papermoney) will be accepted too.)

[  ]  I'll transfer the money to your giro account :
	AccountNR :   47401793
	BLZ :	      80053572  Stadtsparkasse Dessau





