================================================================== StickSoft REGISTRATION FORM - FAX SHEET [Fax number: (503) 774-9243] PAGE 1 OF 1 ================================================================== BLAST DOORS Name (please print)___________________________________________________________ Address ______________________________________________________________________ Address ______________________________________________________________________ City _______________________ St./Prov. _________________ ZIP/Code ____________ Country (if not USA) ____________________ Phone/Fax __________________________ Total Payment: $______________ Notes: Payment must be in U.S. dollars and drawn against a U.S. bank. Make checks payable to "StickSoft Corporation". Cash sent by mail can be stolen. Sticksoft is not responsible for funds lost in this fashion. Payment type: [ ] Visa [ ] MasterCard [ ] Discover [ ] Check [ ] Money Order [ ] Cash Card number: _________________________________________________________________ Expiration date: _____/_____ (MM/YY) Signature: _____________________________ Mail to: StickSoft Corporation 3959 SE Hawthorne Blvd. Ste. 264 Portland, OR 97214 Phone: (503) 774-9243 Where do you get or buy StickSoft shareware games (check favorite two only)? [ ] CompuServe [ ] America Online [ ] HappyPuppy.Com [ ] Other Online Site -- Please write name: [ ] Shareware Catalog -- Please write name: [ ] Work, a friend or a relative [ ] Retail store, off a rack, in a box or other simple packaging [ ] CD-ROM disk [ ] Other:__________________________________________________________________ What do you like or dislike about StickSoft, our games, business with us, etc.? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Thank you!