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Text File  |  1999-01-09  |  2KB  |  58 lines
  1.  
  2.                        JACKPOT SLOTS 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 code the day we receive your
  21.                            order.
  22.  
  23.      DISK SIZE:  (  ) 3-1/2" Diskette   (  ) CD-ROM Disc
  24.  
  25.      I AM ORDERING:
  26.         (  ) JACKPOT SLOTS (ú14)
  27.         (  ) PARADISE SLOTS (ú14)
  28.         (  ) EXTREME SLOTS (ú14)
  29.         (  ) Any Two Above--mark choices (ú21)
  30.         (  ) All Three (ú24)
  31.  
  32.      POSTAGE & PACKING
  33.      -----------------
  34.      Please add ú3 for postage charges if you would like us to send the software
  35.      to you.  If you already have the software and only require the registration
  36.      code, then there is no additional P&P fee.
  37.  
  38.      Amount Enclosed: $_________
  39.  
  40.      Make your check or money order payable to GAMESCAPE STUDIOS.
  41.  
  42.      Mail payment and registration form to:    GAMESCAPE STUDIOS
  43.                                                Egloshayle
  44.                                                Wadebridge
  45.                                                Cornwall
  46.                                                PL27 6AX
  47.                                                UNITED KINGDOM
  48.      Payment Method:
  49.                      ___ Check   ___ Money Order   ___ VISA   ___ MasterCard
  50.  
  51.      Credit Card Number #_____ - _____ - _____ - _____   expiry ____/____
  52.  
  53.      For credit card orders:  Call 01208 816323 (Orders and Information)
  54.                                    01208 816006 (FAX)
  55.  
  56.      Order Online at:         http://www.gamescapestudios.com/order.htm
  57.  
  58.