		   *** RemoteAccess REGISTRATION FORM ***


	  Sysop Name _________________________________________________
	
	  System Name ________________________________________________
	
	  [The above two items are used to generate your registration  
	   key and must appear EXACTLY as they do in RACONFIG.]
	
	
	  FidoNet Address (number and network name) __________________
	
	
	  Internet Address  __________________________________________
	
	
	  Primary BBS telephone number and baud ______________________ 

	
	  Voice telephone number _____________________________________
	
	
	  Hours of BBS operation _____________________________________
	
	
	  Postal Address :
	
	  ____________________________________________________________
	
	  ____________________________________________________________
  
	  ____________________________________________________________
	
	

	  Version of RemoteAccess registering ______.
	
	
	  Registration amount enclosed _______, for ____ copies.
	  (Registration is $50.00 USDollars per key)        
	
	  If using a charge card, you may use our Internet registration
	  site - BMT Micro.  But the above information must be provided
	  in order that we may create your RA.KEY registration file.

	  If paying by check or money order, please mail a copy of this 
	  completed form along with your check or money order to:
		
		Bruce Morse, RemoteAccess Central
		360 Kingsbury Ave
		Haverhill, MA 01835
