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Text File  |  1995-01-28  |  2KB  |  62 lines
  1.                      ===========================
  2.                       DESCENT REGISTRATION FORM 
  3.                      ===========================
  4.  
  5.               YES, I'd like to receive registered Descent!
  6.  
  7.                          CALL 1-800-INTERPLAY,
  8.  return completed form via fax, mail, email, or see your local retailer!
  9.  
  10.  
  11.        NAME:_____________________________________________________
  12.  
  13.     ADDRESS:_____________________________________________________
  14.  
  15.             _____________________________________________________
  16.  
  17.        CITY:________________________ STATE/PROV:_________________ 
  18.  
  19.    ZIP CODE:____________________ PHONE/FAX:______________________
  20.  
  21.                              COUNTRY (if not USA):_______________
  22.  
  23.                      U.S. orders: $39.95 per copy 
  24.                  European orders: £29.99 per copy 
  25.                                                    
  26.            U.S. ORDERS:  _____ copies @ $39.95 ea : _______ 
  27.  
  28.                       shipping add $4.50 per copy : _______
  29.  
  30.           California residents add 6.75% sales tax: _______
  31.  
  32.        EUROPEAN ORDERS:  _____ copies @ £29.99 ea : _______ 
  33.  
  34.                                   >> TOTAL PAYMENT: _______
  35.  
  36. CHOOSE LANGUAGE:  ( ) English  ( ) French  ( ) German
  37.  
  38. PAYMENT TYPE: ( ) Check  ( ) Money Order
  39.               ( ) Visa   ( ) MasterCard   ( ) American Express
  40.  
  41. CARD NUMBER:_____________________________________________________
  42.  
  43. EXPIRATION DATE:_____/_____   SIGNATURE:_________________________
  44.  
  45. NAME ON CREDIT CARD (if different from above):___________________
  46.  
  47.             Make checks payable to Interplay Productions
  48.  
  49.   U.S. ORDERS MAIL TO:       OR CALL:
  50.      Interplay Productions     voice: 1-800-INTERPLAY (468-3775)
  51.      5070 Santa Fe Street        fax: 619-490-9232
  52.      San Diego, CA  92109      email: orderdesk@interplay.com
  53.  
  54.   EUROPEAN ORDERS:
  55.      Mr. Lee Ginty           voice: 011-44-707-675-757
  56.      Computermates         fax: 011-44-707-875-513
  57.      The Wheel, Robin Way
  58.      Cuffley  Herts EN6 4BR
  59.      England
  60.  
  61.  
  62.