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  1.                               
  2.            Duke Nukem' (tm) Extension Set One Shareware Registration
  3.                               
  4.                                  Tony Kamin        
  5.                              333 Northern Avenue
  6.                             Green Bay, WI   54303
  7.                              
  8.  
  9.  
  10. Quantity                                           Price        Total
  11. ______________________________________________________________________________
  12.  
  13. ________ Duke Nukem' Ext Set One Registered Ver.   $5.00ea   _______.___
  14.  
  15.                                         Shipping - $1.00     _____$1.00_
  16.  
  17.  
  18.                                               Order Total    _______.___
  19.  
  20.     Please send check or money order to the name and address above, drawn 
  21.     on US Bank for full amount. Canadian Postal Money Order in US Dollars 
  22.     or International Bank draft also accepted.
  23.  
  24.  
  25. Ship To:     Name  ______________________________________________
  26.  
  27.           Address  ______________________________________________
  28.  
  29.              City  _______________________ State ____ Zip _______
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