(WAS) MINI ARCADE ORDER FORM (c)1995  E-Mail: tipstir@aol.com

For the Shareware User who is registering   SHOTGUN - HOTEL

O-US Residents - Registration fee is $5.00 plus $1.55 S+H = $6.55  US funds!

O-Non US Residents Registration fee is $5.00 + $5.00 S+H = $10.00  USD only!

Please note, don't forget to include the $1.55 for S+H, thank you if you live

in the USA or $5.00 for S+H for those of you who live outside the USA.

You are required to register this game and send in your register fee

above for this game to the author below at his address;

Mail this form to:

 Albert C. Ashton

 19395 Liberty Rd

 Boca Raton, FL 33434-2644

Please make your Check or Money Order payable to: Albert C. Ashton

Any questions please call  (407) 487-7572 (voice only)

(Please fill in below and send this form to above address)

_______________________________________________________________________

Name

_______________________________________________________________________

Address

_______________________________________________________________________

City                                   State                   Zip

_______________________________________________________________________

Phone                                                           Fax

_______________________________________________________________________

Any additional games you would like to add on to your registration today?

_______________________________________________________________________

What is your online screen name from (AOL)  or Internet address name?)

Where did you hear about us from? (Online Forum Service, CD-ROM, BBS etc..?)

_______________________________________________________________________

What type of computer do you have 386, 486, P5, P6? Sound Card 8 or 16 Bit?

US.FORM REV.1995 (WAS # 10) MINI ARCADE SERIES VERSION 2.0  HS 8

6/95