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/ Monster Media 1996 #15 / Monster Media Number 15 (Monster Media)(July 1996).ISO / games / gemq101.zip / ORDER.FRM < prev    next >
Text File  |  1995-09-14  |  2KB  |  57 lines
  1.  
  2.  
  3.  
  4.                            G-QUEST - Deluxe Edition
  5.                                   Order Form
  6.  
  7.  
  8.                               Price         Quantity        Total
  9.            --------------------------------------------------------
  10.             G-QUEST
  11.            Deluxe Edition    $19.95    x    ________   =   ________
  12.  
  13.  
  14.                    Only available on 3 1/2 inch floppy disk!
  15.  
  16.         Name ___________________________________________________________
  17.  
  18.         Street ________________________________________  Apt.  _________
  19.  
  20.         City _____________________________  State ______  Zip __________
  21.  
  22.         Phone (optional) (_______) ______-__________
  23.  
  24.  
  25.         Enclose check or money order payable in U.S. funds to:
  26.  
  27.                             William D. Rinehart
  28.                             P.O. Box 891424
  29.                             Houston, TX 77289
  30.  
  31.  
  32.         Opinions and suggestions: ____________________________________
  33.  
  34.         ______________________________________________________________
  35.  
  36.         ______________________________________________________________
  37.  
  38.  
  39.          The following information is optional, and will be used to
  40.          help the author determine what types of hardware and
  41.          software to support.  Please describe your computer system:
  42.  
  43.         Monitor type:     Standard VGA ___   Super VGA ___
  44.  
  45.         Dos Version: ____________    Computer Speed: ________ MHz
  46.  
  47.         Computer Manufacturer: __________________________________
  48.  
  49.         Do you have a joystick?     YES ___  NO ___
  50.  
  51.  
  52.           As a G-QUEST customer, your opinion is highly valued!  What
  53.            type of game would you like to the author to create next?
  54.  
  55.         ______________________________________________________________
  56.  
  57.         ______________________________________________________________