home *** CD-ROM | disk | FTP | other *** search
/ ftp.wwiv.com / ftp.wwiv.com.zip / ftp.wwiv.com / pub / DOOR / 2100A102.ZIP / ORDER.FRM < prev    next >
Text File  |  1995-01-01  |  2KB  |  52 lines
  1. ==========================================================================
  2.                      RPG-2100 * THE AWAKENING v1.02
  3. ==========================================================================
  4.  
  5.          YOUR NAME : _____________________________________________________
  6.  
  7.       BBS NAME : _____________________________________________________
  8.                          [Exactly as it will appear in registration]
  9.  
  10.     POSTAL ADDRESS : ______________________________________________________
  11.  
  12.                      ______________________________________________________
  13.  
  14.                      ______________________________________________________
  15.  
  16.   I-NET E-MAIL ADDRESS : __________________________________ [IF APPLICABLE]
  17.  
  18.   HOW DID YOU GET A COPY OF THE GAME ______________________________________
  19.  
  20.  
  21.                                   ___
  22. I WISH TO RECEIVE MY ORDER BY:   |   | - CONVENTIONAL MAIL                                      
  23.                                  |___|                                           
  24.                                   ___                                               
  25.                                  |   | - INTERNET E-MAIL                                       
  26.                                  |___|                                                                
  27.                                                                          
  28.  
  29.           ___
  30.          |   | - I am a registered user of
  31.          |___|   other RPG-2100 games     _______________________________
  32.                                           [ Enter game name & reg Code# ]
  33.                                           [ Your reg fee is only US $15 ] 
  34.                                           [+CALIFORNIA tax if applicable]
  35.  
  36.           ___
  37.          |   | - I am not a registered user [ Your reg. fee is US $20   ]
  38.          |___|   of other RPG-2100 games    [ +CALIF. tax if applicable ] 
  39.                                          
  40.  
  41.  
  42. SEND CHECK OR MONEY ORDERS PAYABLE TO:
  43.     
  44.                 CARLOS R. GARCIA
  45.                  259 N. CAPITOL AV. #187
  46.                 SAN JOSE, CALIFORNIA, 95127
  47.  
  48.  
  49. +-- OFFICIAL USE ONLY -----------------------------------------------+----+
  50. |                                                                    |    |
  51. | Rcvd: _________  Key: _____________________  S/N: _________________|    |
  52. +--------------------------------------------------------------------+----+