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/ Inside Mac Games Volume 3 #11 / IMG 32 Nov 1995.iso / More Goodies / Goodies from October / Scenarios and Add-Ons / Realmz Scenarios / Assault Giant Mountain 2.2.2 ƒ / Exile Order Form < prev    next >
Text File  |  1995-08-05  |  2KB  |  51 lines
  1. Exile Registration / Order Form
  2.  
  3. Mail this completed form with payment to:
  4.  
  5. Fantasoft, LLC
  6. P.O. Box 14261
  7. Madison, WI 53714-0261
  8. USA
  9.  
  10. OR Phone/Fax this information to us at:  (414) 963-4429
  11.  
  12. OR  e-mail information below to:  74163.45@Compuserve.com
  13.  
  14.  
  15. Registration Code for Exile                                   
  16. To find out the registration code, select 'Shareware Info' from the title screen of Exile.
  17.  
  18. Registration Code for Exile Character Editor                                    
  19. To find out the registration code, select "Registration Info" from the menu.
  20.  
  21. Without this, we cannot process your order.
  22.  
  23. Last Name                                                                             First Name                                 
  24.  
  25. Address                                                                                                              Apt#             
  26.  
  27.                                                                                                                                                 
  28.  
  29. City                                                   State                   Zip                   Country                       
  30.  
  31. E-Mail Address:                                                                                                                       
  32.  
  33. I would like to register:
  34. Exile: Escape From The Pit..........(Make sure you filled in your code above)........NO          YES           ($25)
  35.  
  36. The Exile Character Editor...........(Make sure you filled in your code above)........NO          YES            ($10)
  37.  
  38. I would like to order by mail:
  39. The hint booklet to Exile...........................................................................................NO          YES            ($6.50)
  40.  
  41. *Foreign orders add $2 for disk postage.    *Total Due = $           
  42.  
  43. Method of Payment:        [  ]  Cash            [  ] Visa
  44.                                                                     [  ]  Check          [  ] Mastercard
  45.  
  46. ___________________________________________________________________
  47. Account Number                                                                                                                                                Exp Date
  48.  
  49. ___________________________________________________________________
  50. Name exactly as it appears on the credit card
  51.