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  1. ===============================[ ORDER FORM ]=================================
  2. LOMAX Software                           questions or comments :
  3. Kettelerstr.27                           +49 (0) 5973 / 5724
  4. 48485 Neuenkirchen                       Lomaxsoft@aol.com
  5. Germany                                  100625.1745@compuserve.com
  6.                                          http://www.lomaxsoft.simplenet.com/
  7. ==============================================================================
  8.  
  9.  
  10. 1.  Please mark the games you want to register and be sure to fill in all
  11.     required information.
  12.  
  13.   ---------------------------------------------------------------------------
  14.   | TITLE                                               | QNT | US$ | Total |
  15.   ---------------------------------------------------------------------------
  16.   | DIAMCO (Windows)                                    |     |14.95|       |
  17.   ---------------------------------------------------------------------------
  18.   | Terroid                                             |     |29.95|       |
  19.   ---------------------------------------------------------------------------
  20.   | FAROCAR (Windows)                                   |     |19.95|       |
  21.   ---------------------------------------------------------------------------
  22.   | Lomax ColTris                                       |     |24.95|       |
  23.   ---------------------------------------------------------------------------
  24.   | Lomax Boulders                                      |     |29.95|       |
  25.   ---------------------------------------------------------------------------
  26.   | Lomax Boulders II - Sea of Diamonds                 |     |29.95|       |
  27.   ---------------------------------------------------------------------------
  28.   | StoneBreaker                                        |     |24.95|       |
  29.   ---------------------------------------------------------------------------
  30.   | Hidden Fields                                       |     |29.95|       |
  31.   ---------------------------------------------------------------------------
  32.   | Magics                                              |     |14.00|       |
  33.   ---------------------------------------------------------------------------
  34.   | Mega Collection: StoneBreaker,                      |     |49.95|       |
  35.   | Hidden Fields and Magics                            |     |     |       |
  36.   ---------------------------------------------------------------------------
  37.   | DIAMCO            (SHAREWAREVERSION)                |     | 4.00|       |
  38.   ---------------------------------------------------------------------------
  39.   | Terroid           (SHAREWAREVERSION)                |     | 4.00|       |
  40.   ---------------------------------------------------------------------------
  41.   | FAROCAR           (SHAREWAREVERSION)                |     | 4.00|       |
  42.   ---------------------------------------------------------------------------
  43.   | Lomax ColTris     (SHAREWAREVERSION)                |     | 4.00|       |
  44.   ---------------------------------------------------------------------------
  45.   | Lomax Boulders    (SHAREWAREVERSION)                |     | 4.00|       |
  46.   ---------------------------------------------------------------------------
  47.   | Lomax Boulders II (SHAREWAREVERSION)                |     | 4.00|       |
  48.   ---------------------------------------------------------------------------
  49.   | StoneBreaker      (SHAREWAREVERSION)                |     | 4.00|       |
  50.   ---------------------------------------------------------------------------
  51.   | Hidden Fields     (SHAREWAREVERSION)                |     | 4.00|       |
  52.   ---------------------------------------------------------------------------
  53.   | Magics            (SHAREWAREVERSION)                |     | 4.00|       |
  54.   ---------------------------------------------------------------------------
  55.   | Shipping and Handling                               |  1  | 4.00|  4.00 |
  56.   ---------------------------------------------------------------------------
  57.   | If ordering from outside Europe add extra           |     | 2.00|       |
  58.   ---------------------------------------------------------------------------
  59.   | Foreign Bank Transaction Fee (if you send no US$) 1*|     | 2.00|       |
  60.   ---------------------------------------------------------------------------
  61.                                                         |   Total:  |       |
  62.                                                         ---------------------
  63.  
  64. 1* Only choose this if you send another currency than US dollars. You can
  65.    also send us the equivalent total of money in your country's currency,
  66.    but then you must choose this and pay 2.00 dollars extra.
  67.  
  68.  
  69.  
  70. 2. Please take the time to tell us how you got your shareware copy of 
  71.    Lomax Boulders II - Sea of Diamonds:
  72.  
  73. [ ] America Online 
  74. [ ] CompuServe (Name of forum): ____________________________________________
  75. [ ] Friend
  76. [ ] PsL
  77. [ ] Local BBS (Name & #): __________________________________________________
  78. [ ] Catalog (Name): ________________________________________________________
  79. [ ] CD (Name): _____________________________________________________________
  80. [ ] Other (Please specify): ________________________________________________
  81.  
  82. 3. Is this your first order with LOMAX Software:  
  83.   
  84. [ ] Yes                  [ ] No
  85.  
  86. 4. Please choose disk size:  
  87.  
  88. [ ]   5 1/4   1.2MB      [ ]   3 1/2   1.4MB
  89.  
  90. 5. Please choose payment type:      
  91.  
  92. [ ] Check                [ ] Money Order
  93.  
  94. 6. Please ship my order to:
  95.  
  96.        First Name: _________________________________________
  97.         
  98.         Last Name: _________________________________________
  99.         
  100.           Address: _________________________________________
  101.         
  102.              City: _________________________________________
  103.         
  104.   Zip/Postal Code: _________________________________________
  105.    
  106.             State: _________________________________________
  107.         
  108.           Country: _________________________________________
  109.         
  110.           Phone #: (___________)____________________________
  111.  
  112.  
  113.         Signature: _________________________________________
  114.  
  115. ALL ORDERS SHIPPED WITHIN 48 HOURS.
  116. THANKS FOR ORDERING.
  117.  
  118. =============================================================================
  119. If you are ordering from North America, you may also order from 
  120. PsL (CREDIT CARD ORDERING ONLY). Please check DEALERS.EXE for details. 
  121.  
  122. CompuServe members WORLDWIDE may also order their registered copy of 
  123. Lomax Boulders II - Sea of Diamonds through the shareware registration 
  124. service (GO SWREG). Please check DEALERS.EXE for details. 
  125.  
  126. Thank you!
  127. =============================================================================
  128.