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  1.    ===========================
  2.    AGCRUMP SOFTWARE ORDER FORM
  3.    ===========================
  4.  
  5.                ** Mark all software you wish to order **
  6.  
  7.    [  ] Dirty Hearts                      ($10)
  8.    [  ] Horse Basketball                  ($10)
  9.    [  ] Infinite Spades                   ($10)
  10.    [  ] Lucky Lotto                       ($10)
  11.    [  ] Mancala 2000                      ($10)
  12.    [  ] Pitty Pat                         ($10)
  13.    [  ] Shark Dominoes                    ($10)
  14.    [  ] Solitaire Gold Pack               ($10)
  15.    [  ] Strategist Checkers               ($10)
  16.    [  ] Tonk                              ($10)
  17.    [  ] Ultimate Bid Whist                ($10)
  18.    [  ] WARI 2000                         ($10)
  19.  
  20.    DISK SIZE: [  ] 3.5" 1.44M  [  ] 3.5" 720K  [  ] 5.25" 1.2M
  21.  
  22.    OPERATING SYSTEM: [  ] DOS_____   [  ] WINDOWS_____
  23.  
  24.    COMPUTER:  [  ] PENTIUM/586  [  ] 486  [  ] 386  [  ] 286
  25.  
  26.    Name (please print)___________________________________________________
  27.  
  28.    Address ______________________________________________________________
  29.  
  30.    Address ______________________________________________________________
  31.  
  32.    City ______________________State/Province_______________ZIP___________
  33.  
  34.    Country _______________________ Phone/Fax_____________________________
  35.  
  36.    E-mail________________________________________________________________
  37.  
  38.    Where did you find our software? _____________________________________
  39.        (example - AOL, Compuserve, Internet, etc.)
  40.  
  41.  
  42.    Total payment: $ ___________
  43.    Note: Payment should be in U.S. dollars and drawn against a U.S. bank.
  44.  
  45.  
  46.    Mail to: AGCrump                   E-mail: ao545@lafn.org
  47.             P.O. Box 8216
  48.             Inglewood, CA 90308
  49.  
  50.    Make check or money order payable to "AGCrump".
  51.    Allow up to two weeks for delivery. All items subject to availability.
  52.    All prices subject to change without notice.
  53.  
  54.    Thank you!