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  1.                                                                 ORDER FORM
  2.  
  3. Name ________________________________________________________________
  4.  
  5. Address _____________________________________________________________
  6.  
  7. City _______________________________ State ______ ZIP _______________
  8.  
  9. Country (if outside USA) ____________________________________________
  10.  
  11. Phone ____________________________________________
  12.  
  13. Price of Fire and Ice registered version                       $29.95
  14. Shipping and Handling (US)                                        4.00
  15. Shipping and Handling (Canada)                                  4.00
  16. Shipping and Handling (all other countries)                  6.00
  17. Illinois residents add sales tax                                       2.28
  18.                                                              
  19. Make check or money order payable to "Streetwise Interactive"           Total enclosed:  $
  20. Master Card/Visa information (credit card orders only)
  21.  
  22. Card number __________________________________________
  23.  
  24. Expiration number ____________________________________
  25. ---------------------------------------------------------------------------
  26. VOLUNTARY QUESTIONS:  Please help us determine what features you would like
  27. ====================  in future products.
  28.  
  29. Circle what type of equipment you have:   8088    286    386    486    Pentium
  30. Circle the speed of your computer(Mhz): 12  16  20  25  33  40  50  66  ___ 
  31. Circle any that apply: Joystick  Mouse  Modem_______  SVGA card____________
  32.                                                                (speed)                 (type)
  33. Sound Capability:  Adlib   Sound Blaster   SB Pro   SB 16   SB AWE32 Other _____________
  34.  
  35. Where did you get Fire and Ice?
  36.     Friend   CompuServe   AOL   Prodigy   Ryan's Bar   Exec-PC   Channel 1
  37.     Invention Factory   Fully Automatic   Sound Advice   World Data Network
  38.     BBS (name): _______________________
  39.     Shareware Distributor (name): _________________________________________
  40.  
  41. Are you a game player?  Please answer the following questions about what you
  42. like and don't like in computer games.
  43.  
  44. Approx. # of retail games owned: ____  #Registered shareware games: ____
  45.  
  46. Circle preference:        Beautiful Graphics     Game Complexity 
  47. Circle preference:    Solo against computer   -OR-   Modem 2-Player
  48. Circle preference:    Strategy    Action    Simulation    Other_________
  49. Long term game playability:   Few Levels w/ hard difficulty   Lotsa Levels
  50. ---------------------------------------------------------------------------
  51. Send this order form and your check or money order to:
  52. Streetwise Interactive, 1101 Tall Timbers #208 Schaumburg, Il 60173 
  53. U.S. order line (MC\VISA) ONLY: 800-242-4775.  Fax: 708-925-8648.
  54. Overseas order line: 708-925-8330
  55. All other inquries including tech support, information and product
  56. details Please call 708-925-8330
  57.  
  58.