home *** CD-ROM | disk | FTP | other *** search
- (Print this file, fill it it and send it to:
- Esoterica, PO Box 302, Cardiff, United Kingdom, CF2 3XP)
-
- EITHER ------------------
-
- Please rush me my full copy of Runes (PC Version). I have enclosed a
- cheque or postal order for ú___________ (All cheques must be made out in Sterling only)
-
- OR ----------------------
-
- I am paying ú___________ by VISA/MASTERCARD/JCB
-
- Card Number: __________________________________________
-
- Expiry Date: __________________________________________
-
- -------------------------
-
-
- NAME: _________________________ (Full Name as it appears on the Credit Card)
-
- ADDRESS: __________________________________________
-
-
- __________________________________________
-
-
- __________________________________________
-
-
- TOWN/CITY:____________________________
-
- POSTCODE: ______ ______
- /ZIPCODE
-
- COUNTRY: ____________________________
-
-
-
- Signature: __________________________________________ (Necessary for credit card orders)