Electron Hut Order Form

To order by mail or fax, print out this form, and fill out all the information requested. You may order by credit card by faxing this form to (408) 984-1764. Or mail it along with a check to:

Electron Hut
P.O. Box 127
Santa Clara, CA 95052-0127

Description Quantity $ each Total
Klondike Solitaire for Palm  $12.00 
FreeCell Solitaire for Palm  $12.00 
Sokoban for Palm  $12.00 
Vegas Slots for Palm  $12.00 
 Total: 

**** PLEASE PRINT CLEARLY ***** PLEASE PRINT CLEARLY ***
If we cannot read your handwriting, we will not process your order and may not be able to reach you if your email address is not legible.

User Information:

Email address: ___________________________________

Palm Username: ________________________________

To find your Palm username, run any of our games and from the opening screen, click the 'Unlock' button. Your username will be displayed. Please double check that you have written it correctly on this form or the serial number we send you will not work.

Payment method:

( ) Check enclosed. NOTE: Checks MUST be US funds, drawn on a US bank.

or

( ) Credit card (Visa, MasterCard, American Express)
Number:________________________
Expiration Date:________________________
Name on Card:________________________
Signature:________________________
Billing address: (required)
Address:________________________
________________________
City:________________________
State:________________________
Zip:________________________
(optional) Phone:________________________