home *** CD-ROM | disk | FTP | other *** search
/ Las Vegas Classics / LASVEGAS.BIN / LASVEGAS / CHINCHEC / CC_ORDER.TXT < prev    next >
Encoding:
Text File  |  1992-05-01  |  2.1 KB  |  58 lines
  1.  
  2.  
  3.                                  ImagiSOFT, Inc.
  4.  
  5.                       CHINESE CHECKERS REGISTRATION FORM
  6.  
  7.  
  8.          Quantity   Description                   Price       Total
  9.          -------------------------------------------------------------
  10.          |      | Chinese Checkers              |  $19.95  |         |
  11.          -------------------------------------------------------------
  12.          |      | Sales Tax (NM Residents Only) |    1.15  |         |
  13.          -------------------------------------------------------------
  14.          |      | Shipping  (Outside USA Only)  |    3.00  |         |
  15.          -------------------------------------------------------------
  16.                                      TOTAL AMOUNT ENCLOSED |         |
  17.                                                            -----------
  18.          Make checks payable to ImagiSOFT, Inc.
  19.          Personal  checks  must be drawn on a US  bank.   If  ordering
  20.          outside the United States, please use a credit card.
  21.  
  22.          Disk Size:  ___ 5.25"  ___ 3.5"
  23.  
  24.          [ ] Check   [ ] VISA   [ ] Master Card   [ ] American Express
  25.  
  26.          Card Number:  _____ _____ _____ _____     Exp. Date:  _______
  27.  
  28.  
  29.          Name: _______________________________________________________
  30.  
  31.          Address: ____________________________________________________
  32.  
  33.          City: _______________________________________________________
  34.  
  35.          State / Country: ____________________________________________
  36.  
  37.          Zip / Postal Code: __________________________________________
  38.  
  39.  
  40.          I received Chinese Checkers from:
  41.            [ ] friend          [ ] disk vendor      [ ] user group
  42.            [ ] free BBS        [ ] pay BBS          [ ] other
  43.  
  44.          Name of vendor, BBS, friend, etc. ___________________________
  45.  
  46.          Comments, suggestions:
  47.  
  48.  
  49.  
  50.  
  51.                   Mail to:             ImagiSOFT, Inc.
  52.                                        Computer Games Division
  53.                                        P.O. Box 13208
  54.                                        Albuquerque, NM   USA   87192
  55.  
  56.          Credit Card Orders May Call:  (800) 767-1978
  57.  
  58.