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  1.  
  2.         / \
  3.        /   \                   SUMMIT Software
  4.      //     \                 14567 Woodbine Ave         Tel: (905) 727-6964
  5.     /        \                 Gormley, Ontario          Fax: (905) 727-4036
  6.       SUMMIT                   Canada   L0H 1G0
  7.      Software
  8.  
  9. ============================================================================
  10.  
  11.   Please place a check mark in the [ ] boxes below, and add up the total.
  12.  
  13.    [ ] The Jelly Bean Factory:  Addicting hi-res VGA 256-color
  14.         action puzzle game w/digital music & effects.....($20) __________
  15.  
  16.    [ ] Crates:  CGA/EGA Challenging puzzle game..........($13) __________
  17.  
  18.        (Prices include mailing & applicable taxes)
  19.  
  20.                                                          Total __________
  21.  
  22. IMPORTANT!       [ ] 3.5" Disk        [ ] 5.25" Disk
  23.  
  24.     Name: _______________________________________________
  25.  
  26.  Address: _______________________________________________
  27.  
  28.     City: ________________________ State/Prov:_____ Country:_____________
  29.  
  30.  Zip/Post.Code: ____________________  Phone: (    )____________
  31.  
  32. PAYMENT BY:  [ ] Visa   [ ] Cheque   [ ] Money order
  33.  
  34. Card # ____________________  Exp. Date: __/__  Signature: __________________
  35.  
  36.