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  1.  
  2.   INSTANT REGISTRATION FORM
  3.   Just copy this file to your printer, fold, tape, and mail.
  4.   For US orders only; outside US please register direct with author.
  5.  
  6.    Quantity  Description                   Price Total
  7.   +--------+------------------------------+-----+-----+   Jacaranda Jim v4.00
  8.   |        | Humbug text adventure        | $20 |     |   was acquired from:
  9.   +--------+------------------------------+-----+-----+
  10.   |        | Jacaranda Jim text adventure | $15 |     |    [ ] friend
  11.   +--------+------------------------------+-----+-----+    [ ] free BBS
  12.   |        | Blox action game             | $15 |     |    [ ] pay BBS
  13.   +--------+------------------------------+-----+-----+    [ ] disk vendor
  14.   |        | Wilf II action game          | $15 |     |    [ ] user group
  15.   +--------+------------------------------+-----+-----+    [ ] other
  16.                         SHIPPING/HANDLING | $2  |     |   Name of vendor,
  17.                                           +-----+-----+   BBS, etc.:
  18.   Minimum credit card order: $15          TOTAL |     |
  19.   Make checks payable to: Nels Anderson         +-----+   __________________
  20.  
  21.   SEND REGISTRATION TO:                                
  22.    Nels Anderson                                        
  23.    92 Bishop Drive                                     
  24.    Framingham, MA 01701                                 
  25.   
  26.   Disk Size:  ___ 5.25"  ___ 3.5" (add $2 extra for each 3.5" disk ordered)
  27.   
  28.   Payment:  _____ Check (U.S. funds only)   ______ VISA   ______ MasterCard
  29.   
  30.   Card Number:  _______ _______ _______ _______  Expiration Date:  ________
  31.   
  32.   Signature:  _________________________ (credit card orders must be signed)
  33.   
  34.   Name:  __________________________________________________________________
  35.   
  36.   Address:  _______________________________________________________________
  37.   
  38.   City/State/Zip:  ________________________________________________________
  39.  
  40.   Comments, suggestions:
  41.  
  42.  
  43.   JACARANDA JIM v4.00
  44.                                                                   +-----+
  45.                                                                   |Place|
  46.                                                                   |Stamp|
  47.                                                                   |Here!|
  48.                                                                   +-----+
  49.  
  50.  
  51.                               Nels Anderson
  52.                               92 Bishop Drive
  53.                               Framingham, MA 01701     
  54.  
  55.  
  56.