REGISTRATION / ORDER FORM  (Gin SW)      
                                  06/16/94
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   Check one.....      (Ultimate Gin SW-4.00)             Check one.....
                                                                      
   (Prices shown include $3.00 for shipping and handling, foreign orders 
   other than CANADA must add an additional $2.00 for postage)
   
   ___ Gin ------------------------------------ ($13.00)   Disk type.....     
   ___ Gin + Voice pack ----------------------- ($18.00)        
   ___ Gin + Blackjack ------------------------ ($21.00)   ___ 720K (3.50 DD)
   ___ Gin + Blackjack + Voice packs ---------- ($26.00)                     
   ___ Gin + Baccarat ------------------------- ($21.00)   ___ 1.44 (3.50 HD)
   ___ Gin + Baccarat + Voice packs ----------- ($26.00)
   ___ Gin + Blackjack + Baccarat ------------- ($29.00)   ___ 1.20 (5.25 HD)
   ___ Gin + Blackjack + Baccarat + Voice packs ($34.00)
                                    
                                 Software Total $________
                          Ca. Sales tax @ 7.75% $________ (California only)
                                    Grand Total $________
   
   Send check or money order           Your Name:_________________________
   to......
   ACCIDENTAL SOFTWARE                   Address:_________________________
   13245 SKIOMAH RD.                                                         
   APPLE VALLEY, CA. 92308               Address:_________________________ 
                                                                           
   Phone Orders (619) 247-2804    City,State,Zip:_________________________
   
   FOREIGN ORDERS: Send International money order (U.S. currency) or check 
   drawn on a U.S. bank or MasterCard / VISA information.
                                    
   For your convenience, we accept MasterCard or Visa. You may charge the 
   amount of your purchase.  If you decide to charge, send this sheet to 
   ACCIDENTAL SOFTWARE with the following information or call 619-247-2804.
   Fax is available if you call first to alert us of the incoming FAX.   
   
   Check one....
    __                 VISA or MasterCard number __________________________
   |__| VISA          
                       Expiration date ____________________________________
    __                                                              
   |__| MasterCard     Card holders name __________________________________
                       
                       Signature __________________________________________

   Phone orders accepted between 8AM and 8PM Pacific Standard Time, Monday
   through Friday.            (619) 247-2804
   Orders are shipped via U.S. mail.                    (Ultimate Gin 4.00)
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   Shareware Survey:  How did this product come to your attention?
   ___ 1. From a shareware vendor (name) __________________________________.
   ___ 2. From a BBS (name) _______________________________________________.
   ___ 3. From a friend.
   ___ 4. Other (please specify) __________________________________________.
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