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Text File  |  2001-02-13  |  2KB  |  51 lines
  1.                   PLBM PalmOS Games Order Form  February 13, 2001
  2.                   ============================
  3.           P.O. Box 10342, Costa Mesa, CA  92627  (USA)  Dept 1292
  4.  
  5.          Internet: sales@plbm.com or http://www.plbm.com
  6.  
  7.  
  8. Ship To:_______________________________ (Name)
  9.  
  10.         _______________________________ (Address)
  11.  
  12.         _______________________________ (Include Zip)
  13.  
  14. Phone:(_____)__________________ Email:_________________________
  15.  
  16. I am paying by:  [___Check]  [___Money Order]  [___Credit Card]
  17.  
  18. Credit Card Type:  [___Visa]  [___M/C]  [___Discovr]  [___AMEX]
  19.  
  20. Number: _________-__________-_________-_________ Exp:____/_____
  21.  
  22. Cardholder Signature:  ________________________________________
  23.  
  24.    *** All orders shipped VIA EMAIL - WE NEED YOUR EMAIL! ***
  25.  
  26. +==============================================================+
  27. |                                       |         | In-Game    |
  28. |Product Name/Description               |  Price  | Serial #   |
  29. |=======================================+=========+============|
  30. |                                       |         |            |
  31. |PLANDER: Palm Planet Lander            |  $9.95  | PPL_______ |
  32. |                                       |         |            |
  33. |PALMPOP: Palm POP! (puzzle & strategy) |  $9.95  | PPP_______ |
  34. |                                       |         |            |
  35. |BEERKEG: Beer Kegger (arcade action)   |  $9.95  | PBK_______ |
  36. |                                       |         |            |
  37. |STALACT: Palm Stalactites (arcade)     |  $9.95  | PST_______ |
  38. |                                       |         |            |
  39. |SCUDATT: Palm Scud Attack! (arcade)    |  $9.95  | PSA_______ |
  40. |---------------------------------------+---------+--------+---|
  41. |                                       |         |
  42. | California orders add 7.75% Sales tax | _______ |
  43. |---------------------------------------+---------+
  44. |                                       |         |
  45. | ****US DOLLARS ONLY!****       TOTAL: |         |
  46. +=======================================+=========+
  47.  
  48.  
  49. EMAIL ORDERING:  You may fill this order form out and mail it to
  50. sales@plbm.com if you prefer.
  51.