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Text File  |  1994-11-24  |  2KB  |  57 lines

  1.  
  2.  
  3.  
  4.                         Gemstones III - Deluxe Edition
  5.                                   Order Form
  6.  
  7.  
  8.                               Price         Quantity        Total
  9.            --------------------------------------------------------
  10.             Gemstones III
  11.            Deluxe Edition    $19.95    x    ________   =   ________
  12.  
  13.  
  14.         Floppy disk type:  3 1/2" ____   5 1/4" ____
  15.  
  16.         Name ___________________________________________________________
  17.  
  18.         Street ________________________________________  Apt.  _________
  19.  
  20.         City _____________________________  State ______  Zip __________
  21.  
  22.         Phone (optional) (_______) ______-__________
  23.  
  24.  
  25.         Enclose check or money order payable in U.S. funds to:
  26.  
  27.                             William D. Rinehart
  28.                             811 Reseda Dr.
  29.                             Houston, TX 77062
  30.  
  31.  
  32.         Opinions and suggestions: ____________________________________
  33.  
  34.         ______________________________________________________________
  35.  
  36.         ______________________________________________________________
  37.  
  38.  
  39.          The following information is optional, and will be used to
  40.          help the author determine what types of hardware and
  41.          software to support.  Please describe your computer system:
  42.  
  43.         Monitor type:     Standard VGA ___   Super VGA ___
  44.  
  45.         Dos Version: ____________    Computer Speed: ________ MHz
  46.  
  47.         Computer Manufacturer: __________________________________
  48.  
  49.         Do you have a joystick?     YES ___  NO ___
  50.  
  51.  
  52.         As a Gemstones customer, you opion is highly valued!  What type
  53.         of game would you like to the author to create next?
  54.  
  55.         ______________________________________________________________
  56.  
  57.         ______________________________________________________________