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The Latest & Greatest Top 201 Games
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The Latest and Greatest Top 201 Games (Maple Media)(1994).iso
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pslot
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psreg
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Wrap
Text File
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1992-08-22
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2KB
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67 lines
REGISTRATION FORM
Registration entitles the user to full support, major
upgrade notifications, discounts on all programs and future
programs.
VIDEO POKER SLOT
Version 4.OO Registration
Please specify disk size
Registration Fee ( ) 5 1/4" ( ) 3 1/2" $ 15.00
Shipping/Handing $ 3.OO
Foreign orders add $ 5.OO _______
Foreign Orders on International Money Orders
or Credit Card payable in US funds.
Total $ _______
Method of Payment: ( ) Check/Money Order
Drivers Lic. # _________________________
( ) MasterCard ( ) VISA
Credit Card # _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _
Exp. Date _ _ - _ _
Name on Card _____________________________________
Signature _____________________________________
Required on Credit Card Orders
Make Checks/Money Orders payable to:
United Innovations Plus, P.O.Box 21O81, Castro Valley, CA 94546
Phone Order #: 510-886-9036 Fax Order #: 510-886-0818
SHIP TO:
Name _______________________________________________________
Address _______________________________________________________
City _____________________________ St. ______ Zip __________
Phone # (Optional) _ _ _ - _ _ _ - _ _ _ _
Where did you acquire this program? ____________________________
For our records, please indicate your systems display adapter.
___MONO ___CGA ___EGA ___VGA ___SVGA Mouse ___Yes ___No