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/ Software Vault: The Games Collection 1 / software vault.zip / software vault / CDR02 / JACJIM50.ZIP / ORDERFRM.TXT < prev   
Text File  |  1993-06-30  |  3KB  |  57 lines
  1.  
  2.   INSTANT REGISTRATION FORM
  3.   Just copy this file to your printer, fold, tape, and mail.
  4.   For US orders only; outside US please register direct with author.
  5.  
  6.    Quantity  Description                   Price Total
  7.   +--------+------------------------------+-----+-----+   Jacaranda Jim v5.0
  8.   |        | Humbug text adventure        | $20 |     |   was acquired from:
  9.   +--------+------------------------------+-----+-----+
  10.   |        | Jacaranda Jim text adventure | $15 |     |    [ ] friend
  11.   +--------+------------------------------+-----+-----+    [ ] free BBS
  12.   |        | Blox action game             | $15 |     |    [ ] pay BBS
  13.   +--------+------------------------------+-----+-----+    [ ] disk vendor
  14.   |        | Wilf II action game          | $15 |     |    [ ] user group
  15.   +--------+------------------------------+-----+-----+    [ ] other
  16.                         SHIPPING/HANDLING | $2  |     |   Name of vendor,
  17.                                           +-----+-----+   BBS, etc.:
  18.   Minimum credit card order: $15          TOTAL |     |
  19.   Make checks payable to: Nels Anderson         +-----+   __________________
  20.   All prices are in U.S. dollars
  21.  
  22.   SEND REGISTRATION TO:                                
  23.    Nels Anderson                                        
  24.    92 Bishop Drive                                     
  25.    Framingham, MA 01701                                 
  26.   
  27.   Disk Size:  ___ 5.25"  ___ 3.5"
  28.   
  29.   Payment:  _____ Check (U.S. funds only)   ______ VISA   ______ MasterCard
  30.   
  31.   Card Number:  _______ _______ _______ _______  Expiration Date:  ________
  32.   
  33.   Signature:  _________________________ (credit card orders must be signed)
  34.   
  35.   Name:  __________________________________________________________________
  36.   
  37.   Address:  _______________________________________________________________
  38.   
  39.   City/State/Zip:  ________________________________________________________
  40.  
  41.   Comments, suggestions:
  42.  
  43.  
  44.   JACARANDA JIM v5.0
  45.                                                                   +-----+
  46.                                                                   |Place|
  47.                                                                   |Stamp|
  48.                                                                   |Here!|
  49.                                                                   +-----+
  50.  
  51.  
  52.                               Nels Anderson
  53.                               92 Bishop Drive
  54.                               Framingham, MA 01701     
  55.  
  56.  
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