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Text File  |  1996-02-10  |  1.2 KB  |  35 lines
  1.                Synaptic Entertainment ORDER FORM
  2.                    
  3.  
  4. Name (Please Print) ________________________________________________________
  5. Address ____________________________________________________________________
  6. City _________________________ State/Province __________ ZIP _______________
  7. Country (if not USA) ____________________ Phone/Fax ________________________
  8.  
  9. [ ] Medieval Pack  $10.00 (US Dollars)
  10.     (Gargoyle, Gargoyle Revenge and Gargoyle Mania) $10.00 (US Dollars)
  11.  
  12. SHIPPING CHARGES:  |TOTALS:
  13. [ ] USA: $2.50     |Shipping and Handling charges:  $____________
  14. [ ] All other countries: $5.00                      $____________ 
  15.                                               Total $____________
  16.  
  17. Please pay in form of check or money order.
  18.  
  19. Please make check out to: Synaptic Entertainment
  20.  
  21. Mail to:       Synaptic Entertainment  
  22.                Rt.1 Box 124
  23.                Pocasset, ok 73079
  24.  
  25. Where did you get Medieval Pack from?
  26.  
  27. Downloaded from:
  28. [ ]        Other BBS: Name: ________________________________________________
  29. [ ]        Compuserve 
  30. [ ]        America Online (AOL)
  31. [ ]        Genie  
  32. [ ]        Internet FTP Site: Site Name: ___________________________________
  33.    
  34.  
  35.