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Text File  |  1992-01-23  |  1.3 KB  |  46 lines
  1.                           
  2.                           
  3.                           
  4.                           
  5.                           
  6.                           The Las Vegas Bingo Club 
  7.                                 Order Form
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  12.         Name: _______________________________________________________
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  16.         Address: ___________________________________________ APT#:___
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  18.         
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  20.         State: _______________          ZipCode: __________-_________
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  22.         
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  24.         Phone: __________________  
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  29.  
  30.         [  ] - The Las Vegas Bingo Club                       : $10/copy
  31.         [  ] - CyberWars                                      : $12/copy
  32.  
  33.                                                             + : $3 Shipping
  34.                                                             ----------------
  35.                                                         
  36.                                                         
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  38.                                                         Total : $
  39.                                                                   ----------
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  45.              Please Checks and Money Orders ONLY! - NO CASH!
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