home *** CD-ROM | disk | FTP | other *** search
-
-
-
- Data Wave -----=====[ ORDER FORM ]=====----- Data Wave
- ===============================================================================
- SOLD TO:
- Name____________________________________________________
-
- Address____________________________________________________
-
- ____________________________________________________
-
- City__________________________ State______ ZIP _______
-
- Phone__________________________ FAX_____________________
-
- ----+------------------------------------------------------+---------+---------
- QTY | DESC | PRICE | TOTAL
- ----+------------------------------------------------------+---------+---------
- | ROTAKTIX strategy puzzle arcade game 256 color VGA | $19.00 |
- | with sound blaster music and sound effects | |
- ----+------------------------------------------------------+---------+---------
- | FLOATRIS floating blocks arcade game 256 color VGA | $15.00 |
- | with sound blaster music and sound effects | |
- ----+------------------------------------------------------+---------+---------
- | ARCADE puzzle pak. The full deluxe versions of both | |
- | Rotaktix and Floatris. Save $5.00!! | $29.00 |
- ----+------------------------------------------------------+---------+---------
- shipping for destinations in the United States is FREE! | FREE
- ---------------------------------------------------------------------+---------
- International $1.00 for 1 game packs, $2.00 for multi-game |
- shipping: packs. $8.00 for Fedex/UPS/DHL/etc. (specify) |
- ---------------------------------------+-----------------------------+---------
- Subtract Data Wave discount coupon | (coupons are found in the) |
- (only 1 may be redeemed at a time) | (registered versions) |
- ---------------------------------------+---+-------------------------+---------
- [ ] High density [ ] Low density | |
- [ ] 3.5" Disk [ ] 5.25" Disk | GRAND TOTAL |
- -------------------------------------------+-------------------------+---------
-
- *******************************************************************************
- Payment can be made via personal check or money order. International orders
- must have funds drawn on a US bank or an IRC.
- ******************************************************************************
-
- MAIL COMPLETED FORM & PAYMENT TO:
-
- Data Wave
- Suite 457
- 13500 SW Pacific Hwy
- Portland, OR 97223
-
-
- Please allow 2 weeks for domestic orders, 3 weeks for international orders.
-
- We thank you for your order and sincerely hope that you enjoy your Data Wave
- entertainment products as much as we have enjoyed bringing them to you!
-