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  1. ===============================[ ORDER FORM ]=================================
  2. LOMAX Software                           questions or comments :
  3. Kettelerstr.27                           +49 (0) 5973 / 5724
  4. 48485 Neuenkirchen                       Lomaxsoft@aol.com
  5. Germany                                  100625.1745@compuserve.com
  6.                                          http://www.lomaxgames.com/
  7. ==============================================================================
  8.  
  9.  
  10. 1.  Please mark the games you want to register and be sure to fill in all
  11.     required information.
  12.  
  13.   ---------------------------------------------------------------------------
  14.   | TITLE                                               | QNT | US$ | Total |
  15.   ---------------------------------------------------------------------------
  16.   | 3D Mr. Ball (Win95)                                 |     |14.95|       |
  17.   ---------------------------------------------------------------------------
  18.   | LomTrixx (Win95)                                    |     |14.95|       |
  19.   ---------------------------------------------------------------------------
  20.   | 3D-LomTris (Win95)                                  |     |14.95|       |
  21.   ---------------------------------------------------------------------------
  22.   | Lovely Girls (Win95)                                |     |14.95|       |
  23.   ---------------------------------------------------------------------------
  24.   | Cybersphere Plus                                    |     |17.95|       |
  25.   ---------------------------------------------------------------------------
  26.   | Diamco (Windows)                                    |     |14.95|       |
  27.   ---------------------------------------------------------------------------
  28.   | Terroid                                             |     |29.95|       |
  29.   ---------------------------------------------------------------------------
  30.   | Farocar (Windows)                                   |     |19.95|       |
  31.   ---------------------------------------------------------------------------
  32.   | Lomax ColTris                                       |     |24.95|       |
  33.   ---------------------------------------------------------------------------
  34.   | Lomax Boulders                                      |     |19.95|       |
  35.   ---------------------------------------------------------------------------
  36.   | Lomax Boulders II - Sea of Diamonds                 |     |19.95|       |
  37.   ---------------------------------------------------------------------------
  38.   | Lomax Boulders III - Mystic Walls                   |     |19.95|       |
  39.   ---------------------------------------------------------------------------
  40.   | StoneBreaker                                        |     |24.95|       |
  41.   ---------------------------------------------------------------------------
  42.   | Hidden Fields                                       |     |29.95|       |
  43.   ---------------------------------------------------------------------------
  44.   | Magics                                              |     |14.00|       |
  45.   ---------------------------------------------------------------------------
  46.   | LomTrixx          (SHAREWAREVERSION)                |     | 4.00|       |
  47.   ---------------------------------------------------------------------------
  48.   | 3D-LomTris        (SHAREWAREVERSION)                |     | 4.00|       |
  49.   ---------------------------------------------------------------------------
  50.   | Lovely Girls      (SHAREWAREVERSION)                |     | 4.00|       |
  51.   ---------------------------------------------------------------------------
  52.   | Cybersphere Plus  (SHAREWAREVERSION)                |     | 4.00|       |
  53.   ---------------------------------------------------------------------------
  54.   | DIAMCO            (SHAREWAREVERSION)                |     | 4.00|       |
  55.   ---------------------------------------------------------------------------
  56.   | Terroid           (SHAREWAREVERSION)                |     | 4.00|       |
  57.   ---------------------------------------------------------------------------
  58.   | FAROCAR           (SHAREWAREVERSION)                |     | 4.00|       |
  59.   ---------------------------------------------------------------------------
  60.   | Lomax ColTris     (SHAREWAREVERSION)                |     | 4.00|       |
  61.   ---------------------------------------------------------------------------
  62.   | Lomax Boulders    (SHAREWAREVERSION)                |     | 4.00|       |
  63.   ---------------------------------------------------------------------------
  64.   | Lomax Boulders II (SHAREWAREVERSION)                |     | 4.00|       |
  65.   ---------------------------------------------------------------------------
  66.   | Lomax Boulders III(SHAREWAREVERSION)                |     | 4.00|       |
  67.   ---------------------------------------------------------------------------
  68.   | StoneBreaker      (SHAREWAREVERSION)                |     | 4.00|       |
  69.   ---------------------------------------------------------------------------
  70.   | Hidden Fields     (SHAREWAREVERSION)                |     | 4.00|       |
  71.   ---------------------------------------------------------------------------
  72.   | Magics            (SHAREWAREVERSION)                |     | 4.00|       |
  73.   ---------------------------------------------------------------------------
  74.   | Shipping and Handling                               |  1  | 4.00|  4.00 |
  75.   ---------------------------------------------------------------------------
  76.   | If ordering from outside Europe add extra           |     | 2.00|       |
  77.   ---------------------------------------------------------------------------
  78.   | Foreign Bank Transaction Fee (if you send no US$) 1*|     | 2.00|       |
  79.   ---------------------------------------------------------------------------
  80.                                                         |   Total:  |       |
  81.                                                         ---------------------
  82.  
  83. 1* Only choose this if you send another currency than US dollars. You can
  84.    also send us the equivalent total of money in your country's currency,
  85.    but then you must choose this and pay 2.00 dollars extra.
  86.  
  87.  
  88.  
  89. 2. Please take the time to tell us how you got your shareware copy of 
  90.    3D Mr. Ball:
  91.  
  92. [ ] America Online 
  93. [ ] CompuServe (Name of forum): ____________________________________________
  94. [ ] Friend
  95. [ ] PsL
  96. [ ] Local BBS (Name & #): __________________________________________________
  97. [ ] Catalog (Name): ________________________________________________________
  98. [ ] CD (Name): _____________________________________________________________
  99. [ ] Other (Please specify): ________________________________________________
  100.  
  101. 3. Is this your first order with LOMAX Software:  
  102.   
  103. [ ] Yes                  [ ] No
  104.  
  105. 4. Please choose disk size:  
  106.  
  107. [ ]   5 1/4   1.2MB      [ ]   3 1/2   1.4MB
  108.  
  109. 5. Please choose payment type:      
  110.  
  111. [ ] Check                [ ] Money Order
  112.  
  113. 6. Please ship my order to:
  114.  
  115.        First Name: _________________________________________
  116.         
  117.         Last Name: _________________________________________
  118.         
  119.           Address: _________________________________________
  120.         
  121.              City: _________________________________________
  122.         
  123.   Zip/Postal Code: _________________________________________
  124.    
  125.             State: _________________________________________
  126.         
  127.           Country: _________________________________________
  128.         
  129.           Phone #: (___________)____________________________
  130.  
  131.  
  132.         Signature: _________________________________________
  133.  
  134. ALL ORDERS SHIPPED WITHIN 48 HOURS.
  135. THANKS FOR ORDERING.
  136.