Name: Address: City: State: Zip: Country: Email Address: Other Email Address: Location Quantity Price (each) Total USA X $10.00 = $ Other X $20.00 = $ For all NON-USA orders: Please make sure to only pay with US Currency or a Money Order. Send Computer Cuisine Form & Payment to: Mike McGee  Toyama-Ken, Nei-Gun Yatsuo-Machi, Ida 6742 Ayumi So #306 Click On The Box Above! Japan 939-23 (When this form is completed & mailed, you will be emailed the registration password. If you do not have an email account, the password can be sent by Overseas/US Mail.)