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Text File  |  1997-12-30  |  1KB  |  60 lines
  1.  
  2.         to:
  3.  
  4.  
  5.  
  6.          Belly Entertainment
  7.          P.O.Box 167886
  8.          Oregon, Ohio 43616
  9.  
  10.         or
  11.  
  12.         Juergen Fuchs
  13.  
  14.         Hindenburgstr. 36
  15.         D-55278 Mommenheim
  16.         Germany
  17.  
  18.  
  19.  
  20.  
  21.  
  22.         Order
  23.  
  24.  
  25.  
  26.         Name:
  27.  
  28.         Address:
  29.  
  30.         City:                                           ZIP:
  31.  
  32.         Country:
  33.  
  34.         email:
  35.  
  36.  
  37.         I order ___ registrated personal licence(s) of DRAWCAT 
  38.         (DM 30 or US$ 28 each).
  39.         I have enclude the total charge of _______
  40.                 as 
  41.                      _  cheque,
  42.                      _  VISA CARD.
  43.                      _  MASTER CARD,
  44.                      _  cash.
  45.  
  46.         For VISA or MASTER CARD orders please fill in:
  47.  
  48.         Signature:
  49.  
  50.         Name on Card:
  51.  
  52.         Credit Card Number:        Expiration date:
  53.  
  54.         Please send my the registration code 
  55.                 _ per mail
  56.                 _ per email.
  57.  
  58.  
  59.         Date:                    Signature:
  60.