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- RPG-2100 * THE WRAITH OF KHALAL v2.00
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- YOUR NAME : _____________________________________________________
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- BBS NAME : _____________________________________________________
- [Exactly as it will appear in registration]
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- POSTAL ADDRESS : ______________________________________________________
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- ______________________________________________________
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- ______________________________________________________
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- I-NET E-MAIL ADDRESS : __________________________________ [IF APPLICABLE]
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- HOW DID YOU GET A COPY OF THE GAME ______________________________________
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- ___
- I WISH TO RECEIVE MY ORDER BY: | | - CONVENTIONAL MAIL
- |___|
- ___
- | | - INTERNET E-MAIL
- |___|
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- ___
- | | - I am a registered user of
- |___| other RPG-2100 games _______________________________
- [ Enter game name & reg Code# ]
- [ Your reg fee is only US $15 ]
- [+CALIFORNIA tax if applicable]
-
- ___
- | | - I am not a registered user [ Your reg. fee is US $20 ]
- |___| of other RPG-2100 games [ +CALIF. tax if applicable ]
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- SEND CHECK OR MONEY ORDERS PAYABLE TO:
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- CARLOS R. GARCIA
- 259 N. CAPITOL AV. #187
- SAN JOSE, CALIFORNIA, 95127
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- +-- OFFICIAL USE ONLY -----------------------------------------------+----+
- | | |
- | Rcvd: _________ Key: _____________________ S/N: _________________| |
- +--------------------------------------------------------------------+----+