Order Form for ArithmeTick-Tack-Toe
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Please make check or money order payable to:
Indigo Rose Corporation                 Office: (204) 668-8180
P.O. Box 2159                           FAX:    (204) 661-6904
Winnipeg, MB, Canada R3C 3R5            Orders: (800) 665-9668

Please send me _______ copy(ies) of ArithmeTick-Tack-Toe at a cost of 
$15.00 each in US funds.  A shipping charge of $2.00 US within Canada 
and the USA ($5.00 worldwide) will be added to your order.  Please call 
for shipping prices on orders over 5 pieces.

Date:   ___________________________________________________

Name:   ___________________________________________________

Company:___________________________________________________

Address:___________________________________________________

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Email:  ___________________________________________________

Phone:  ___________________   Fax: ________________________

Payment:   [  ] Check/Money Order [  ] American Express [  ] VISA

VISA/AMEX Orders: Name on card:______________________________________

		   Card number:______________________________________

	       Expiration date:______________________________________

	Cardholder's signature: _____________________________________
Cardholder will pay to the issuer of the charge card presented herewith 
the amount stated hereon in accordance with the issuers agreement 
with the cardholder.
I understand that VISA orders will be charged in Canadian funds at the 
current US-Canadian exchange rate.  Your VISA statement will show the 
charge in your local currency to the approximate equivalent of $15.00 
US each + shipping.

Where did you obtain this evaluation version?

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Comments and/or suggestions:

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