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Text File  |  1992-08-03  |  4KB  |  97 lines

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  2. ORDER FORM for Silver Yucca Software Door Products
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  4.           PRODUCT NAME                                      PRICE
  5.  
  6.       (  ) 1. AmoebaWars ($15.00)                            ________
  7.  
  8.       (  ) 2. The Wall ($15.00)                              ________
  9.  
  10.       (  ) 3. HellHaven ($10.00)                             ________
  11.  
  12.       (  ) 4. Werewolves & Wanderers ($10.00)                ________
  13.  
  14.       (  ) 5. Keno Online ($15.00)                           ________
  15.  
  16.       (  ) 6. viewZIP ($2.00)                                ________
  17.  
  18.       (  ) 7. Sixth Sense ($5.00)                            ________
  19.  
  20.       (  ) 8. Riddle Adventure ($10.00)                      ________
  21.  
  22.       (  ) 9. The Delphi Oracle ($10.00)                     ________
  23.  
  24.       (  )10. Guitar Tab Index ($10.00)                      ________
  25.  
  26.       (  )11. Blackjack ($10.00)                             ________
  27.  
  28.       (  )12. Acronym Engine ($10.00)                        ________
  29.  
  30.       (  )13. Slots ($10.00)                                 ________
  31.  
  32.       (  )14. Checkers ($10.00)                              ________
  33.  
  34.       (  )15. Federation ($15.00)                            ________
  35.  
  36.              Shipping                                        _$2.00__
  37.                                                              ========
  38.  
  39.              TOTAL PRICE                                     ________
  40.  
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  42. INFORMATION SHEET (required for processing)
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  44.  
  45.             Date: ___/___/____
  46.  
  47.         YOUR NAME: _________________________________________
  48.  
  49. COMPLETE BBS NAME: _________________________________________
  50.  
  51.      VOICE NUMBER: (___) ___-____             GEnie: _____________
  52.                                           AppleLink: _____________
  53.        BBS NUMBER: (___) ___-____               CIS: _____________
  54.                                             Prodigy: _____________
  55.             HOURS: ____                      Delphi: _____________
  56.                                     America On Line: _____________
  57.              BAUD: ______________               BIX: _____________
  58.                                            Internet: _____________
  59.         FIDO NODE: ______________    PC-Pursuitable? Yes / No
  60.   
  61.  
  62.            UseNet: ______________
  63.  
  64.           RUNNING: ( )Red Ryder Host   ( )Mansion   ( )WWIV
  65.                    ( )Second Sight     ( )Hermes    ( )MUBBS
  66.  
  67.           ADDRESS: ______________________________________
  68.  
  69.              CITY: _____________________________
  70.  
  71.    STATE/PROVINCE: __________________
  72.  
  73.               ZIP: ______________  COUNTRY (if not US) _______________
  74.  
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  76. Comments:
  77.  
  78. ____________________________________________________________________________
  79.  
  80. ____________________________________________________________________________
  81.  
  82. ____________________________________________________________________________
  83.  
  84. ____________________________________________________________________________
  85.  
  86. ____________________________________________________________________________
  87.  
  88.  
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  90.  
  91. Send filled out form to:    Benjamin Kuo
  92.                             Silver Yucca Software
  93.                             3419 East 7590 South
  94.                             Salt Lake City, Utah  84121-5439
  95.  
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  97.