setSystems
P.O. Box 386
Sandy, UT  84091-0386   USA

Mah Jongg Wall ORDER FORM -- for phone, fax, email, or postal orders

[ ] Personal code US$29.95
[ ] Gift Certificate code US$29.95 (enter recipient's name below)
[ ] Both for special price of US$49.95
Recipient's Name:

Your Name:
E-mail Address:

Billing Address (the address your credit card bill is sent to)
  Street:
  City:
  State/Province:
  Zip/Postal code:
  Country:
Mailing Address (if different than billing address)
  Street:
  City:
  State/Province:
  Zip/Postal code:
  Country:

Home Phone Number:                  Work Phone Number:

Credit Card Information
  Type (VISA, MasterCard, American Express, Discover):
  Account Number:
  Expiration Date:

Software to Order
  Title:  Mah Jongg Wall - registration key/code
  Price:  US$29.95 (or US$49.95 personal & gift certificate)
  AL residents add 4% sales tax:  $1.20 (or $2.00)
  Total Dollar Amount:  US$

Where did you hear about "Mah Jongg Wall"?:

If payment is by credit card, please include the following 
language (and sign unless emailed):

I authorize setSystems(TM) to bill my credit card and agree to 
pay the total dollar amount according to card issuer agreement.

Signature _____________________________    Date _____________