AUSTRALIA  ORDER FORM
                         ~~~~~~~~~~~~~~~~~~~~~

Registration can be by one of the following methods:
1)	Cheque
2)	Money Order
3)      Credit Card - American Express, Bankcard, Mastercard, Visa.

To register send payment/order to our local agent:

	SOFTWARE HEAVEN
	PO Box 148
	Brookvale  NSW  2100
	AUSTRALIA
	Phone: (02) 9905-2960
	Fax:   (02) 9905-6251
	E-mail:  jpaulj@ibm.net


Please provide the following information:

Name_____________________________________

Address_____________________________________________________________________

Address_____________________________________________________________________

City___________________ State/Prov.______________Zip/Postal Code____________

Country_____________________________________________________________________

Phone(optional)_______________________ E-Mail (if any)______________________


PELLENC's Products:
~~~~~~~~~~~~~~~~~~

[ ] Bomb Golf License at A$20		_________

[ ] 32 Card Bridge License at A$25	_________

[ ] Hockey Pong License at A$25		_________

    + Shipping:	postal mail A$1 	_________
		E-mail: FREE

			TOTAL		_________


Payment Method:
~~~~~~~~~~~~~~

____ Check/Money Order ____ VISA ____ MasterCard  ____ Am.Express ____ Other

Name exactly as on credit card _________________________________

Credit Card #_______________________________________ Expiration Date__________


Signature ___________________________________________
(Only required for mail in and FAX credit card orders)

Thank you for registering.