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Der Mediaplex Sampler - Die 6 von Plex
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6_v_plex.zip
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DISK1
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REGISTER.TXT
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1991-04-08
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1KB
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44 lines
DOUBLE DOWN VIDEO POKER v1.0 REGISTRATION FORM
All prices are in U.S. funds and effective from 04/08/91.
Item Quantity Price Amount
DOUBLE DOWN VIDEO POKER on a 5¼" disk ________ $10.00 _______
DOUBLE DOWN VIDEO POKER on a 3½" disk ________ $10.00 _______
Printed Manual ________ $1.00 _______
Subtotal _______
California Residents Add 6.5% tax _______
TOTAL _______
Check or money orders only. Checks drawn on Non-U.S. banks or in Non U.S
funds cannot be accepted. Checks must be in U.S. Funds drawn from a U.S
Bank.
Name: ___________________________________________
Address ___________________________________________
___________________________________________
City ________________________ State _______ ZIP ___________
Country ___________________________________________
Phone ( ) _________ - _________________ (optional)
Send this form with payment to:
Sam Hazan
11929 Weddington Street #303
North Hollywood, CA 91607
U.S.A.
Please allow 2-3 weeks for delivery.