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.)