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##                                                                            ##
##  To register with elCID, send this filled form to:                         ##
##                                                                            ##
##  Carsten Scholling                                                         ##
##  Großer Lahweg 34                                                          ##
##  31020 Salzhemmendorf                                                      ##
##  Germany                                                                   ##
##                                                                            ##
##  or via email to:                                                          ##
##                                                                            ##
##  elcid@galaxy5.com                                                         ##
##  cscholling@t-online.de                                                    ##
##  2:2432/1110.18@fidonet                                                    ##
##  39:170/101.18@amiganet                                                    ##
##                                                                            ##
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   Name: ______________________________________________________________


 Street: ______________________________________________________________


    ZIP: __________  City: _____________________________________________



    Tel: ___________________________________


 email : ___________________________________



 The registering fee of DM 30.- ($20 or same amount in other currency)

        o is put by as cheque

        o is put by in cash

        o is transfered to Kto 101 033 157, BLZ 254 501 10
          at the Kreissparkasse Hameln-Pyrmont


        o Please send the keyfile via email (UUEncoded)

        o Please send the keyfile via snail-mail to the above address



OPTIONAL

Source of supply: o Aminet

                  o BBS:         _________________________________

                  o CD:          _________________________________

                  o PD-dispatch: _________________________________

                  o Else:        _________________________________


CPU: ____________   RAM: ________ MB FAST  ________ MB CHIP-RAM


ISDN-Card/Modem: ___________________________________________________

Driver software: ___________________________________________________


Comment: _______________________________________________________________________

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