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Text File  |  1997-04-23  |  2KB  |  54 lines
  1.  
  2.                         ANIMATED BLACKJACK REGISTRATION
  3.  
  4.           Name             ________________________________________
  5.  
  6.           Company          ________________________________________
  7.  
  8.           Address          ________________________________________
  9.  
  10.           City/State       ________________________________________
  11.  
  12.           Zip/Postal Code  ________________________________________
  13.  
  14.           Country          ________________________________________
  15.  
  16.           Phone            ________________________________________
  17.  
  18.           EMAIL ADDRESS    ________________________________________
  19.                            If you include your eMail address, we can
  20.                            send you the immediately.
  21.  
  22.      DISK SIZE:  (  ) 3-1/2"   (  ) CD-ROM
  23.  
  24.      I AM ORDERING:
  25.  
  26.         (  ) ANIMATED BLACKJACK ($20)
  27.  
  28.         (  ) Other Ultisoft Product ________________________________
  29.  
  30.      INTERNATIONAL ORDERS
  31.      --------------------
  32.      Please add $4.00 for shipping if you live outside North America.  
  33.      For shipping to Canada or Mexico, add $2.00.  Payment must be in 
  34.      U.S. funds drawn on a U.S. or Canadian bank. (no charge for 
  35.      shipping within the U.S.)
  36.  
  37.      Amount Enclosed: $_________
  38.  
  39.      Make your check or money order payable to ULTISOFT.
  40.  
  41.      Mail payment and registration form to:    ULTISOFT
  42.                                                PO Box 5015
  43.                                                Central Point, OR 97502
  44.                                                USA
  45.      Payment Method:
  46.                      ___ Check   ___ Money Order   ___ VISA   ___ MasterCard
  47.  
  48.      Credit Card Number #_____ - _____ - _____ - _____   expires ____/____
  49.  
  50.      For credit card orders:  Call 1-800-925-3147 (U.S. and Canada)
  51.                                    1-541-857-9229 (International)
  52.                                    1-541-734-3267 (FAX)
  53.  
  54.